Pathology/Lab Coding Alert

Question: Our lab performed a culture ordered for a patient with a diagnosis of sepsis, and testing identified the organism as Methicillin-resistant Staphylococcus aureus (MRSA). I think we should report the condition as A41.02 and B95.62, but my co-worker disagrees. Who is right?

Tennessee Subscriber

Answer: Whether your co-worker is right depends on her suggestion, but you would not be correct to code the diagnosis as both A41.02 (Sepsis due to Methicillin resistant Staphylococcus aureus) and B95.62 (Methicillin resistant Staphylococcus aureus infection as the cause of diseases classified elsewhere). 

Here’s why: ICD-10 instructs that B95.62 is not necessary if the primary “combination code” identifies the organism as MRSA. Because A41.02 correctly identifies the entire condition — sepsis due to MRSA, you should report A41.02 alone.

If the physician indicated a different condition caused by MRSA that doesn’t have a combination code, you would report the condition code plus B95.62.