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B95.3 ICD-10-CM Code: Streptococcus pneumoniae as the cause of diseases classified elsewhere

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

Billable · FY2027A valid, specific ICD-10-CM code, reportable for dates of service in FY2027.

What you need to know

Source: CMS/NCHS Official ICD-10-CM tabular notes, quoted. From the CMS/NCHS tabular list for the release in force. A note the category or block publishes applies to this code too, and is marked with where it comes from.

The tabular list publishes no instructional note for this code itself.

Where it sits Source: CMS/NCHS

Under:Chapter 1: Certain Infectious and Parasitic DiseasesB95-B97 Bacterial and viral infectious agentsB95 Streptococcus, Staphylococcus, and Enterococcus as the cause of diseases classified elsewhere

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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 v44, Appendix B.

  • MS-DRG 867 — OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH MCC (MDC 18)
  • MS-DRG 868 — OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH CC (MDC 18)
  • MS-DRG 869 — OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITHOUT CC/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.

Don’t confuse B95.3 with…

MedCoder analysis — pairs from this code’s official notes, distinctions written by MedCoder

The codes most likely to be picked instead of B95.3 — named in its own official notes, or sharing its laterality or encounter family — with what separates them and which documentation moves the case. Each links to the full comparison.

  • B95.5— Specificity relationship (Review)

    Overlapping diagnoses in the same category.

    Overlapping codes in the same category — the documentation decides which is the more specific fit.

    What moves you there: A record that documents no more than “Unspecified streptococcus as the cause of diseases classified elsewhere” takes B95.5; specificity in the record moves it back here.

    Full comparison: B95.3 vs B95.5 →

Relationships are read from this code's own official notes, its laterality siblings and its encounter family; the wording of each distinction is MedCoder editorial, and the documentation named in each “what moves you there” line is the official note phrase or sibling title itself. Source: CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a.

Coding context

Guidelines, coding notes, decision aids, relationships (with MS-DRG and CCSR classification), hierarchy, HCC, coverage and the context map: what a coder reaches for after the core. Each section names whether it is official source data, a MedCoder-derived relationship or MedCoder editorial.

Code Overview

Streptococcus pneumoniae as the cause of diseases classified elsewhere is a billable ICD-10-CM diagnosis code (B95.3).

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

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

Chapter 1: Certain Infectious and Parasitic Diseases (A00-B99), U07.1, U09.9 a. Human Immunodeficiency Virus (HIV) Infections 1) Code only confirmed cases

b. Infectious agents as the cause of diseases classified to other chapters Certain infections are classified in chapters other than Chapter 1 and no organism is identified as part of the infection code. In these instances, it is necessary to use an additional code from Chapter 1 to identify the organism. A code from category B95, Streptococcus, Staphylococcus, and Enterococcus as the cause of diseases classified to other chapters, B96, Other bacterial agents as the cause of diseases classified to other chapters, or B97, Viral agents as the cause of diseases classified to other chapters, is to be used as an additional code to identify the organism. An instructional note will be found at the infection code advising that an additional organism code is required.

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.

Chapter 16: Certain Conditions Originating in the Perinatal Period (P00-P96)

f. Bacterial Sepsis of Newborn Category P36, Bacterial sepsis of newborn, includes congenital sepsis. If a perinate is documented as having sepsis without documentation of congenital or community acquired, the default is congenital and a code from category P36 should be assigned. If the P36 code includes the causal organism, an additional code from category B95, Streptococcus, Staphylococcus, and Enterococcus as the cause of diseases classified elsewhere, or B96, Other bacterial agents as the cause of diseases classified elsewhere, should not be assigned. If the P36 code does not include the causal organism, assign an additional code from category B96. If applicable, use additional codes to identify severe sepsis (R65.2-) and any associated acute organ dysfunction.

Verify Before Coding

  • Principal-diagnosis restriction. The Medicare Code Editor lists this code as unacceptable as a principal diagnosis: it describes a circumstance influencing health status rather than a current illness or injury being treated. It is valid as a secondary diagnosis.

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-derived relationships — computed from published CMS and AHRQ datasets

Other codes that name B95.3 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: A49 — Bacterial infection of unspecified site (via B95.-).

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

Referenced by 69 Use Additional Code instructions across 12 chapters: D59.31 — Infection-associated hemolytic-uremic syndrome, E06.0 — Acute thyroiditis (via B95.-), G00.2 — Streptococcal meningitis, G06 — Intracranial and intraspinal abscess and granuloma (via B95.-), H65 — Nonsuppurative otitis media (via B95.-), I30.1 — Infective pericarditis (via B95.-), I33.0 — Acute and subacute infective endocarditis (via B95.-), I40.0 — Infective myocarditis (via B95.-), J01 — Acute sinusitis (via B95.-), J02.8 — Acute pharyngitis due to other specified organisms (via B95.-), J03.8 — Acute tonsillitis due to other specified organisms (via B95.-), J04 — Acute laryngitis and tracheitis (via B95.-), J05 — Acute obstructive laryngitis [croup] and epiglottitis (via B95.-), J06.9 — Acute upper respiratory infection, unspecified (via B95.-), J32 — Chronic sinusitis (via B95.-), J36 — Peritonsillar abscess (via B95.-), J37 — Chronic laryngitis and laryngotracheitis (via B95.-), J85 — Abscess of lung and mediastinum (via B95.-), J86 — Pyothorax (via B95.-), J95.851 — Ventilator associated pneumonia (via B95.-), +49 more.

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

MS-DRG Grouper Relationships (FY2027)

Potential MS-DRG participation — not a DRG assignment.

FY2027 MS-DRG: not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity for that release.

Named in the grouper logic of 3 MS-DRGs: DRG 867 (MDC 18), DRG 868 (MDC 18), DRG 869 (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):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

Principal diagnosis restriction (Medicare Code Editor)

Not acceptable as a principal diagnosis on an inpatient claim.

Same clinical category (CCSR)

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

+399 more

Contextual Map

Every relationship of B95.3 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 B95.3 with these 9 related codes in Claim Check

Hierarchy

Referenced by Excludes1 notes

Referenced by Use Additional Code instructions (69)

Clinical classification (CCSR)

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 · FY2027

Index entries

  • Infection, infected, infective (opportunistic), bacterial NOS, as cause of disease classified elsewhere, Streptococcus, pneumoniae[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Infection, infected, infective (opportunistic), pneumococcus, pneumococcal NEC, as cause of disease classified elsewhere[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Streptococcus, streptococcal, pneumoniae, as cause of disease classified elsewhere[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027

Nearest codes (11)

Change history

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

Reference

Index terms and tables, published questions and FAQ, every source behind this page with its release and checksum, the date-of-service check and the complete change history.

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.

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 FY2027 tabular list, index and tables, effective October 1, 2026 Release, file and checksum · Publisher’s page
Coding guidelines Official source data
ICD-10-CM Official Guidelines for Coding and Reporting (FY2027), quoted by section Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v44.0 (October 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 — v44 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-derived 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 editorial 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.

Current data releases:ICD-10-CM FY2027 · ICD-10-PCS FY2027 · HCPCS October 2026 · MS-DRG v44 · Medicare Code Editor v44.0 · NCCI PTP Q4 2026 · MUE Q4 2026 · NCD code lists 2026-01 · LCD export September 28, 2026 · All releases and sources

Labels on this page: Official source data · MedCoder-derived relationship · MedCoder editorial explanation. How to read the labels · All data sources and release dates · CMS coding rules

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. "B95.3 — Streptococcus pneumoniae as the cause of diseases classified elsewhere." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/b95.3-streptococcus-pneumoniae-as-the-cause-of-diseases-classified-elsewhere

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Streptococcus pneumoniae as the cause of diseases classified elsewhere

No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027, 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 B95.3 in its code family, with their registry titles.

View all codes in the B95 family