A36.86 ICD-10-CM Code: Diphtheritic conjunctivitis
Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.
Inpatient Payment Groups (MS-DRG)
Potential MS-DRG participation — not a DRG assignment.
MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v43, Appendix B.
- MS-DRG 124 — OTHER DISORDERS OF THE EYE WITH MCC OR THROMBOLYTIC AGENT (MDC 02)
- MS-DRG 125 — OTHER DISORDERS OF THE EYE WITHOUT MCC (MDC 02)
A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.
Code Overview
MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.
Indexed Clinical Terms (3)
Official source data — entries quoted as published, in the Index’s own lookup phrasing
Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code. These are alphabetic-index entries shown as the Index writes them — lookup phrasing, not necessarily the wording of a final diagnosis.
Verify Before Coding
- CC as a secondary diagnosis (FY2026). Can raise the stay's MS-DRG severity tier.
From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.
Relationships & Classification
MedCoder structured relationships — computed from published CMS and AHRQ datasets
MS-DRG Grouper Relationships (FY2026)
Potential MS-DRG participation — not a DRG assignment.
FY2026 MS-DRG: CC — Complication or Comorbidity. Reported as a secondary diagnosis, this code raises the stay's MS-DRG severity tier — except when the principal diagnosis is one of 12 clinically related codes on its CMS exclusion list.
Named in the grouper logic of 2 MS-DRGs: DRG 124 (MDC 02), DRG 125 (MDC 02).
From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.
Clinical classification (AHRQ CCSR):EYE001 — Cornea and external disease (default); INF003 — Bacterial infections.
Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.
Related Codes
Same clinical process (MS-DRG)
Acts as CC — raises the severity of other admissions. CMS groups these diagnoses into one MS-DRG principal-diagnosis exclusion process — a CC/MCC on this list never raises severity when the principal diagnosis is also on it.
A36.0 — Pharyngeal diphtheria, A36.1 — Nasopharyngeal diphtheria, A36.2 — Laryngeal diphtheria, A36.3 — Cutaneous diphtheria, A36.81 — Diphtheritic cardiomyopathy, A36.82 — Diphtheritic radiculomyelitis, A36.83 — Diphtheritic polyneuritis, A36.84 — Diphtheritic tubulo-interstitial nephropathy, A36.85 — Diphtheritic cystitis, A36.89 — Other diphtheritic complications, A36.9 — Diphtheria, unspecified
Same clinical category (CCSR)
AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical categories (Cornea and external disease, Bacterial infections).
Same Index main term, other category
The ICD-10-CM Index to Diseases and Injuries files this code under the main terms “Conjunctivitis NOS”, “Ophthalmia”; these codes share that main term but sit in a different category of the Tabular List.
A18.59 — Other tuberculosis of eye (tuberculous), A21.1 — Oculoglandular tularemia (tularemic), A39.89 — Other meningococcal infections (meningococcal), A52.71 — Late syphilitic oculopathy (in, syphilis), A54.31 — Gonococcal conjunctivitis (gonococcal), A71.0 — Initial stage of trachoma (trachomatous, acute), A71.1 — Active stage of trachoma (Egyptian), A74.0 — Chlamydial conjunctivitis (inclusion), B00.53 — Herpesviral conjunctivitis (in, herpesvirus), B02.31 — Zoster conjunctivitis (in, zoster), B30.1 — Conjunctivitis due to adenovirus (adenoviral), B30.2 — Viral pharyngoconjunctivitis (Béal's), B30.3 — Acute epidemic hemorrhagic conjunctivitis (enteroviral) (Apollo), B30.8 — Other viral conjunctivitis (Newcastle), B30.9 — Viral conjunctivitis, unspecified (viral), B55.2 — Mucocutaneous leishmaniasis (in, mucocutaneous leishmaniasis), B60.12 — Conjunctivitis due to Acanthamoeba (Acanthamoeba), B74.9 — Filariasis, unspecified (in, filariasis), B94.0 — Sequelae of trachoma (granular, sequelae), B99 — Other and unspecified infectious diseases (in, infectious disease NEC), +18 more
Contextual Map
Every relationship of A36.86 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.
Hierarchy
- A00-B99 — Chapter 1: Certain Infectious and Parasitic Diseases (A00-B99) (A00-B99)[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- A30-A49 — Other bacterial diseases[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
Clinical classification (CCSR)
- EYE001 — Cornea and external disease[CCSR]— AHRQ CCSR for ICD-10-CM Diagnoses (HCUP)
- INF003 — Bacterial infections[CCSR]— AHRQ CCSR for ICD-10-CM Diagnoses (HCUP)
MS-DRG Grouper
- CC — Complication or Comorbidity [MS-DRG severity]: “As a secondary diagnosis this code can raise the stay's MS-DRG severity tier (CC).”— CMS MS-DRG Definitions Manual (Appendix C) · FY2026
- DRG 124 — OTHER DISORDERS OF THE EYE WITH MCC OR THROMBOLYTIC AGENT[MS-DRG]: “OTHER DISORDERS OF THE EYE WITH MCC OR THROMBOLYTIC AGENT (MDC 02)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026
- DRG 125 — OTHER DISORDERS OF THE EYE WITHOUT MCC[MS-DRG]: “OTHER DISORDERS OF THE EYE WITHOUT MCC (MDC 02)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026
MDC crossing
- MDC 02 — Diseases and Disorders of the Eye[MDC crossing]: “Diseases and Disorders of the Eye — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs. 1,200 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2026
Index entries
- Conjunctivitis NOS (staphylococcal) (streptococcal), diphtheritic[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
- Conjunctivitis NOS (staphylococcal) (streptococcal), in (due to), diphtheria[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
- Ophthalmia, diphtheritic[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
Nearest codes (13)
- A36 — Diphtheria[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- A36.0 — Pharyngeal diphtheria[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- A36.1 — Nasopharyngeal diphtheria[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- A36.2 — Laryngeal diphtheria[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- A36.3 — Cutaneous diphtheria[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- A36.8 — Other diphtheria[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- A36.81 — Diphtheritic cardiomyopathy[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- A36.82 — Diphtheritic radiculomyelitis[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
- and 5 more
Change history
- FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016
Sources for this page
Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.
- Code, title, tabular notes and index terms Official source data
- CMS/CDC ICD-10-CM FY2026 tabular list, index and tables, effective October 1, 2025 Release, file and checksum · Publisher’s page
- Claim edits Official source data
- CMS Definitions of Medicare Code Edits — v43.1 (April 2026) Release, file and checksum · Publisher’s page
- Inpatient payment groups Official source data
- CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v43 Release, file and checksum · Publisher’s page
- Change history and date-of-service validity Official source data
- CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
- Comparisons, relationships and the contextual map MedCoder structured relationship
- Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
- Summary and FAQ answers MedCoder explanation
- Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.
Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates
Cite this page
Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.
MedCoder.ai. "A36.86 — Diphtheritic conjunctivitis." ICD-10-CM FY2026. https://medcoder.ai/icd10/code/a36.86-diphtheritic-conjunctivitis
Change history
- FY2016 — October 1, 2015In the code set at ICD-10-CM adoptionDiphtheritic conjunctivitis
No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027 (effective October 1, 2026), and none are recorded for this code. Note changes are tracked from FY2027 only.
Nearest Codes in This Family
Official ICD-10-CM classifications closest to A36.86 in its code family, with their registry titles.
- A36.2 — Laryngeal diphtheria
- A36.3 — Cutaneous diphtheria
- A36.8 — Other diphtheria
- A36.81 — Diphtheritic cardiomyopathy
- A36.82 — Diphtheritic radiculomyelitis
- A36.83 — Diphtheritic polyneuritis
- A36.84 — Diphtheritic tubulo-interstitial nephropathy
- A36.85 — Diphtheritic cystitis
- A36.89 — Other diphtheritic complications
- A36.9 — Diphtheria, unspecified