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Question: A patient who returned from an overseas trip a week ago reports to the emergency department (ED) with a high fever they report having for nearly 48 hours. The patient also suffers from fatigue and loss of appetite, along with a severe headache. The ED physician’s final diagnosis was simply “typhoid fever.” I’m looking at the ICD-10-CM options, and it looks like they are more detailed than I expected. How do I choose the correct typhoid fever diagnosis code?

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Answer: You’re right; the correct typhoid fever code depends on how the infection affects the patient. The complications could impact the patient’s brain, heart, lungs, or other vital organs or systems. There are different ICD-10 codes for different types of typhoid fever in the A01.0- (Typhoid fever) code set.

Do this: Go back and check the encounter notes for specific information on how the infection impacted the patient; the symptoms you listed in your question could indicate just about any type of typhoid fever. Then, choose one of the following diagnosis codes for the patient’s typhoid fever:

• A01.00 (Typhoid fever, unspecified). Use this code when there is no indication as to how the infection affects the patient.
• A01.01 (Typhoid meningitis). Use this code when encounter notes indicate that the infection affects the membranes that protect the brain and spinal cord (meninges).
• A01.02 (Typhoid fever with heart involvement). Use this code when encounter notes indicate that the infection causes myocardial and/or pericardial inflammation.
• A01.03 (Typhoid pneumonia). Use this code when encounter notes indicate that the infection affects the lungs.
• A01.04 (Typhoid arthritis) Use this code when encounter notes indicate that the infection affects the joints.
• A01.05 (Typhoid osteomyelitis). Use this code when encounter notes indicate that the infection causes bone inflammation that occurs when the infection spreads to the bone.
• A01.09 (Typhoid fever with other complications). Use this code when the infection causes complications not listed in any of the other A01.0- diagnosis codes.

More on typhoid: Though it isn’t common in the United States, typhoid fever is still a problem in some parts of the world. Travelers can sometimes return with the condition, particularly if they go somewhere that typhoid is endemic or to a place with unsanitary conditions (especially those areas with contaminated water). It also isn’t unusual for patients to start feeling typhoid fever after a period of symptomatic dormancy; it can take one or two weeks for typhoid fever symptoms to present in a patient.

Chris Boucher, MS, CPC, Senior Development Editor, AAPC