Pulmonology Coding Alert

Question: What codes should I use to report a diagnosis of pneumonia due to Methicillin resistant Staphylococcus aureus (MRSA)?

Pennsylvania Subscriber

Answer: You’ll assign only one code for this diagnosis, and that’s J15.212 (Pneumonia due to Methicillin resistant Staphylococcus aureus).

Code J15.212 is a combination code that brings together the patient’s condition and the causal condition into one code. According to the ICD-10-CM Official Guidelines, section I.C.1.e.1.a, “When a patient is diagnosed with an infection that is due to [MRSA], and that infection has a combination code that includes a causal organism (e.g., sepsis, pneumonia) assign the appropriate combination code for the condition.”

MRSA is a strain of the Staphylococcus aureus bacteria that has developed a resistance to certain antibiotics, such as penicillins and cephalosporins.