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A40.8 ICD-10-CM Code: Other streptococcal sepsis

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Coding at a Glance

Tabular directives
3 Excludes1 · 6 code-first instructions
Risk adjustment
CMS-HCC V28: 1 category · CMS-HCC V22 category 2

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 870 — SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS (MDC 18)
  • MS-DRG 871 — SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC (MDC 18)
  • MS-DRG 872 — SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC (MDC 18)

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.

Risk Adjustment (CMS-HCC)

Payment categories this diagnosis maps to under CMS-HCC V28, payment year 2026.

  • HCC 2 — Septicemia, Sepsis, Systemic Inflammatory Response Syndrome/Shock

Other models: CMS-HCC V22 HCC 2

Risk scores depend on the enrollee's full accepted diagnosis set and segment; a category mapping alone does not determine payment.

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for A40.8 in the official ICD-10-CM tabular list, quoted as published.

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

Notes without a marker are published on A40.8 itself; “inherited from” names the category or block whose note applies here.

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).

Source: inherited from A40

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-)

Source: inherited from A40

Coder workflow for A40.8

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

Before you code A40.8

  1. “Other” (NEC) means the condition is specified in the record but no dedicated code captures it. Confirm the documented form is not one a sibling code names before settling on A40.8; if the record states no specifics at all, the unspecified sibling applies instead. “Other” codes are for documented conditions the classification gives no specific code; “unspecified” codes are for records lacking the detail (Guidelines I.A.9.a, I.A.9.b).

    ReviewA40.0, A40.1, A40.3

    See the relationships section · Guide: Other vs unspecified (NEC vs NOS) →

  2. Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with A40.8. 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 a condition named in A40.8’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

  2. Is the underlying (etiologic) condition the Code First note names documented?
    Yes → Sequence the underlying condition first, then A40.8.
    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 A40.8. 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).
Any detail beyond this code’s title
What the record states that a more specific sibling code would capture — or its absence, which itself supports the unspecified code.

Official instructions as workflow

  • Excludes1 — check before selecting A40.8(3 notes)

    Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with A40.8: 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 A40.8. 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 A40.8 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

Other streptococcal sepsis is a billable ICD-10-CM diagnosis code (A40.8).

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 (1)

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.

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

  • MCC 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

Other codes that name A40.8 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 (via A40.-).

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 (via A40.-), N16 — Renal tubulo-interstitial disorders in diseases classified elsewhere (via A40.-).

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 5 Use Additional Code instructions: K94.02 — Colostomy infection (via A40.-), K94.12 — Enterostomy infection (via A40.-), K94.22 — Gastrostomy infection (via A40.-), K95.01 — Infection due to gastric band procedure (via A40.-), K95.81 — Infection due to other bariatric procedure (via A40.-).

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

MS-DRG Grouper Relationships (FY2026)

Potential MS-DRG participation — not a DRG assignment.

FY2026 MS-DRG: MCC — Major 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 46 clinically related codes on its CMS exclusion list.

Named in the grouper logic of 3 MS-DRGs: DRG 870 (MDC 18), DRG 871 (MDC 18), DRG 872 (MDC 18).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):INF002 — Septicemia (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 MCC — 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.

A02.1 — Salmonella sepsis, A20.7 — Septicemic plague, A22.7 — Anthrax sepsis, A26.7 — Erysipelothrix sepsis, A32.7 — Listerial sepsis, A39.2 — Acute meningococcemia, A39.3 — Chronic meningococcemia, A39.4 — Meningococcemia, unspecified, A40.0 — Sepsis due to streptococcus, group A, A40.1 — Sepsis due to streptococcus, group B, A40.9 — Streptococcal sepsis, unspecified, A41.01 — Sepsis due to Methicillin susceptible Staphylococcus aureus, A41.02 — Sepsis due to Methicillin resistant Staphylococcus aureus, A41.1 — Sepsis due to other specified staphylococcus, A41.2 — Sepsis due to unspecified staphylococcus, A41.3 — Sepsis due to Hemophilus influenzae, A41.4 — Sepsis due to anaerobes, A41.50 — Gram-negative sepsis, unspecified, A41.51 — Sepsis due to Escherichia coli [E. coli], A41.52 — Sepsis due to Pseudomonas, +25 more

Same CMS-HCC risk category (V28)

CMS maps these diagnoses to the same Hierarchical Condition Category (Septicemia, Sepsis, Systemic Inflammatory Response Syndrome/Shock) for risk-adjusted payment.

A20.7 — Septicemic plague, A22.7 — Anthrax sepsis, A26.7 — Erysipelothrix sepsis, A32.7 — Listerial sepsis, A39.2 — Acute meningococcemia, A39.3 — Chronic meningococcemia, A39.4 — Meningococcemia, unspecified, A40.0 — Sepsis due to streptococcus, group A, A40.1 — Sepsis due to streptococcus, group B, A40.3 — Sepsis due to Streptococcus pneumoniae, A40.9 — Streptococcal sepsis, unspecified, A41.01 — Sepsis due to Methicillin susceptible Staphylococcus aureus, A41.02 — Sepsis due to Methicillin resistant Staphylococcus aureus, A41.1 — Sepsis due to other specified staphylococcus, A41.2 — Sepsis due to unspecified staphylococcus, A41.3 — Sepsis due to Hemophilus influenzae, A41.4 — Sepsis due to anaerobes, A41.50 — Gram-negative sepsis, unspecified, A41.51 — Sepsis due to Escherichia coli [E. coli], A41.52 — Sepsis due to Pseudomonas, +31 more

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical categories (Septicemia, Bacterial infections).

A02.1 — Salmonella sepsis, A20.7 — Septicemic plague, A22.7 — Anthrax sepsis, A26.7 — Erysipelothrix sepsis, A32.7 — Listerial sepsis, A39.2 — Acute meningococcemia, A39.4 — Meningococcemia, unspecified, A40.0 — Sepsis due to streptococcus, group A, A40.1 — Sepsis due to streptococcus, group B, A40.3 — Sepsis due to Streptococcus pneumoniae, A40.9 — Streptococcal sepsis, unspecified, A41.01 — Sepsis due to Methicillin susceptible Staphylococcus aureus, A41.02 — Sepsis due to Methicillin resistant Staphylococcus aureus, A41.1 — Sepsis due to other specified staphylococcus, A41.2 — Sepsis due to unspecified staphylococcus, A41.3 — Sepsis due to Hemophilus influenzae, A41.4 — Sepsis due to anaerobes, A41.50 — Gram-negative sepsis, unspecified, A41.51 — Sepsis due to Escherichia coli [E. coli], A41.52 — Sepsis due to Pseudomonas, +392 more

Same Index main term, other category

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

A24.0 — Glanders (malleus), A24.1 — Acute and fulminating melioidosis (melioidosis), A26.7 — Erysipelothrix sepsis (Erysipelothrix), A28.0 — Pasteurellosis (Pasteurella multocida), A28.2 — Extraintestinal yersiniosis (extraintestinal yersiniosis), A32.7 — Listerial sepsis (Listeria monocytogenes), A39.1 — Waterhouse-Friderichsen syndrome (adrenal hemorrhage syndrome), A39.2 — Acute meningococcemia (meningococcal, acute), A39.3 — Chronic meningococcemia (meningococcal, chronic), A39.4 — Meningococcemia, unspecified (meningococcal), A41.01 — Sepsis due to Methicillin susceptible Staphylococcus aureus (MSSA), A41.02 — Sepsis due to Methicillin resistant Staphylococcus aureus (MRSA), A41.1 — Sepsis due to other specified staphylococcus (Staphylococcus, staphylococcal, specified NEC), A41.2 — Sepsis due to unspecified staphylococcus (Staphylococcus, staphylococcal), A41.3 — Sepsis due to Hemophilus influenzae (Haemophilus influenzae), A41.4 — Sepsis due to anaerobes (anaerobic), A41.50 — Gram-negative sepsis, unspecified (Gram-negative), A41.51 — Sepsis due to Escherichia coli [E. coli] (Escherichia coli), A41.52 — Sepsis due to Pseudomonas (Pseudomonas), A41.53 — Sepsis due to Serratia (Serratia), +88 more

Lab tests where this diagnosis supports Medicare coverage (NCD)

Medicare's National Coverage Determination (NCD) program lists this diagnosis as medical justification for these lab tests.

Blood Glucose Test, Gamma-glutamyl Transferase (GGT) Test

Contextual Map

Every relationship of A40.8 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 A40.8 with these 8 related codes in Claim Check

Hierarchy

Referenced by Excludes1 notes

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

Referenced by Code First instructions

Referenced by Use Additional Code instructions

Clinical classification (CCSR)

Risk adjustment (CMS-HCC)

  • HCC 2 — Septicemia, Sepsis, Systemic Inflammatory Response Syndrome/Shock [CMS-HCC]— CMS-HCC V28 · 2026

MS-DRG Grouper

MDC crossing

  • MDC 18 — Infectious and Parasitic Diseases, Systemic or Unspecified Sites[MDC crossing]: “Infectious and Parasitic Diseases, Systemic or Unspecified Sites — 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 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2026

Index entries

  • Sepsis (generalized) (unspecified organism), Streptococcus, streptococcal, specified NEC[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026

Nearest codes

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
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
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
Risk adjustment Official source data
2026 Mid-Year Final ICD-10 Mappings + Model Software (cms.gov/files/zip/2026-midyear-final-icd-10-mappings.zip, 2026-midyear-final-model-software.zip) — CMS-HCC V28, PY2026 mid-year final release 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. "A40.8 — Other streptococcal sepsis." ICD-10-CM FY2026. https://medcoder.ai/icd10/code/a40.8-other-streptococcal-sepsis

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Other 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 A40.8 in its code family, with their registry titles.

View all codes in the A40 family