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A40 ICD-10-CM Code: Streptococcal sepsis

Billing Status: NO. This is a clinician non-billable / parent hierarchy grouping in the ICD-10-CM system.

Coding at a Glance

Tabular directives
3 Excludes1 · 6 code-first instructions

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for A40 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2026Effective: October 1, 2025

Excludes1 — Not Coded Here

Conditions generally not reported together with this code (Excludes1) -- an error unless the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Code First

Underlying conditions that must be sequenced before this code.

  • Code first, if applicable, postprocedural sepsis (T81.44-)
  • sepsis due to central venous catheter (T80.211-)
  • streptococcal sepsis during labor (O75.3)
  • streptococcal sepsis following abortion or ectopic or molar pregnancy (O03.37, O03.87, O04.87, O07.37, O08.82)
  • streptococcal sepsis following immunization (T88.0-)
  • streptococcal sepsis following infusion, transfusion or therapeutic injection (T80.22-, T80.29-)

Coder workflow for A40

MedCoder structured workflow — derived from this code’s own official record

Before you code A40

  1. A40 is not reportable as written. Select the more specific code beneath it that the documentation supports. Codes are reported to the highest level of specificity the classification provides (Guidelines I.B.2).

    ReviewA40.0, A40.1, A40.3, A40.8, A40.9

    See the relationships section · Guide: How to choose an ICD-10-CM code →

  2. Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with A40. Excludes1 conditions are not reported together with this code unless the record shows they are unrelated (Guidelines I.A.12.a).

    See the official tabular notes

Choose the right path

  1. Does the documentation support one of the more specific codes beneath A40?
    Yes → Select that code and continue the checks below on its own page.
    No → A40 cannot be reported as written; query for the specificity its subcategory needs.

    ReviewA40.0, A40.1, A40.3, A40.8, A40.9

  2. Does the documentation support a condition named in A40’s Excludes1 note?
    Yes → Do not simply proceed: review the excluded code. Both are reported only when the record shows the two conditions are unrelated.
    No → Continue.

    ReviewO85, A41.81

  3. Is the underlying (etiologic) condition the Code First note names documented?
    Yes → Sequence the underlying condition first, then A40.
    No → Continue; do not add an underlying condition the record does not document.

    ReviewT81.44, T80.211, O75.3, O03.37, O03.87, O04.87

Consider A40. Then confirm the code is valid for the date of service in the Verify section.

Documentation check

The provider’s diagnostic statement
Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).
The underlying (etiologic) condition
Named in the Code First note; sequenced before this code when documented (Guidelines I.A.13).

Official instructions as workflow

  • Excludes1 — check before selecting A40(3 notes)

    Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with A40: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.

    CompareO85, A41.81

    See the official tabular notes · Guidelines I.A.12.a

  • Code First — sequencing check(6 notes)

    Coding workflow: Check whether the underlying or etiologic condition the note names is documented. When it is, sequence it before A40. Do not add an underlying condition the record does not document.

    ReviewT81.44, T80.211, O75.3, O03.37, O03.87, O04.87

    See the official tabular notes · Guidelines I.A.13

Coding decision scenarios

Pattern scenarios for this code’s structure — decision rules, not clinical cases

Documentation: Both the condition A40 describes and a condition named in its Excludes1 note are documented for the same encounter.

Coding question: Can both codes be reported?

Path: Review the Excludes1 note and the excluded code, and look for a provider statement on whether the two conditions are related.

Reason: Excludes1 means the two are not coded together; the exception is when the record shows the conditions are unrelated to each other (Guidelines I.A.12.a).

ReviewO85, A41.81

Documentation: The underlying condition the Code First note names is documented alongside this condition.

Coding question: How are the two sequenced?

Path: Review the Code First note.

Reason: The underlying condition is sequenced first and the manifestation follows (Guidelines I.A.13).

ReviewT81.44, T80.211, O75.3, O03.37, O03.87, O04.87

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Code Overview

Streptococcal sepsis is a non-billable ICD-10-CM category code (A40). A more specific billable subcode must be selected for claims submission.

MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.

Official Coding Guidelines

Official source data — quoted verbatim from the CMS/NCHS Official Guidelines

Official source data — quoted verbatim from the CMS/NCHS Official Guidelines

Verbatim excerpts from the ICD-10-CM Official Guidelines for Coding and Reporting (CMS/NCHS) that govern this code.

Chapter 15: Pregnancy, Childbirth, and the Puerperium (O00-O9A)

k. Puerperal sepsis Code O85, Puerperal sepsis, should be assigned with a secondary code to identify the causal organism (e.g., for a bacterial infection, assign a code from category B95-B96, Bacterial infections in conditions classified elsewhere). A code from category A40, Streptococcal sepsis, or A41, Other sepsis, should not be used for puerperal sepsis. If applicable, use additional codes to identify severe sepsis (R65.2-) and any associated acute organ dysfunction.

Verify Before Coding

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

Other codes that name A40 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.

Referenced by 1 Excludes1 note: A41 — Other sepsis.

These codes’ tabular lists mark this diagnosis as mutually exclusive — not reported together unless the conditions are documented as unrelated.

Referenced by 2 Code First instructions: N08 — Glomerular disorders in diseases classified elsewhere, N16 — Renal tubulo-interstitial disorders in diseases classified elsewhere.

Each of these codes carries a Code First note naming this condition — when that code is reported, THIS code is sequenced first, ahead of it.

Referenced by 6 Use Additional Code instructions across 2 chapters: J95.02 — Infection of tracheostomy stoma, K94.02 — Colostomy infection, K94.12 — Enterostomy infection, K94.22 — Gastrostomy infection, K95.01 — Infection due to gastric band procedure, K95.81 — Infection due to other bariatric procedure.

These codes instruct coders to additionally report this code when it applies.

Related Codes

Same Index main term, other category

The ICD-10-CM Index to Diseases and Injuries files this code under the main term “Glomerulonephritis”; these codes share that main term but sit in a different category of the Tabular List.

A01.09 — Typhoid fever with other complications (in, typhoid fever), A41.9 — Sepsis, unspecified organism (in, sepsis), A50.59 — Other late congenital syphilis, symptomatic (in, syphiliscongenital), B52.0 — Plasmodium malariae malaria with nephropathy (in, Plasmodium malariae), B65.9 — Schistosomiasis, unspecified (in, bilharziasis), B78.9 — Strongyloidiasis, unspecified (in, strongyloidiasis), C88.0 — Waldenström macroglobulinemia (in, Waldenström macroglobulinemia), C90.0 — Multiple myeloma (in, multiple myeloma), D65 — Disseminated intravascular coagulation [defibrination syndrome] (in, defibrination syndrome), D69.0 — Allergic purpura (in, Henochpurpura), D89.1 — Cryoglobulinemia (in, cryoglobulinemia), E75.21 — Fabry (-Anderson) disease (in, Fabrydisease), E78.6 — Lipoprotein deficiency (in, lecithin cholesterol acyltransferase deficiency), E85.4 — Organ-limited amyloidosis (in, amyloidosis), I33.0 — Acute and subacute infective endocarditis (in, subacute bacterial endocarditis), M31.0 — Hypersensitivity angiitis (in, Goodpasture's syndrome), M31.19 — Other thrombotic microangiopathy (in, thrombotic thrombocytopenic purpura), M31.31 — Wegener's granulomatosis with renal involvement (in, Wegener's granulomatosis), M31.7 — Microscopic polyangiitis (in, microscopic polyangiitis), M32.14 — Glomerular disease in systemic lupus erythematosus (proliferative NEC, diffuse), +15 more

Contextual Map

Every relationship of A40 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.

Run A40 with these 23 related codes in Claim Check

Hierarchy

Excludes1

Code First (11)

Referenced by Excludes1 notes

  • A41 — Other sepsis[Excludes1]: “streptococcal sepsis (A40.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026

Referenced by Code First instructions

Referenced by Use Additional Code instructions

Nearest codes

Change history

  • FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016

Common coding questions

Can A40 be billed directly?

No. A40 (Streptococcal sepsis) is a non-billable ICD-10-CM category code. A more specific billable subcode must be selected based on clinical documentation.

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
Coding guidelines Official source data
ICD-10-CM Official Guidelines for Coding and Reporting (FY2026), quoted by section 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
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

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Streptococcal sepsis

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 A40 in its code family, with their registry titles.