ICD Code A04.72

ICD code A04.72 is enterocolitis caused by Clostridium difficile infection, where it is not specified whether the infection is a recurrence.

1. Patient presents with symptoms of diarrhea, abdominal pain, and fever.

2. Laboratory testing confirms the presence of Clostridium difficile toxin or organism in stool.

3. Clinical evaluation indicates inflammation of the colon and/or small intestine (enterocolitis).

4. No documentation or evidence of prior episodes of Clostridium difficile infection (not recurrent).

5. No alternative cause identified for the enterocolitis symptoms.

Relevant CPT codes that may be used to treat ICD code A04.72 include:

- 87493 (Infectious agent detection by nucleic acid [DNA or RNA]; Clostridium difficile, amplified probe technique)

- 87511 (Infectious agent detection by nucleic acid [DNA or RNA]; Clostridium, direct probe technique)

- 87512 (Infectious agent detection by nucleic acid [DNA or RNA]; Clostridium, amplified probe technique)

- 87513 (Infectious agent detection by nucleic acid [DNA or RNA]; Clostridium, quantification)

- 99202–99215 (Evaluation and management services, new or established patient office visits)

- 96365 (Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour)

- 96401 (Chemotherapy administration, subcutaneous or intramuscular; non-hormonal anti-infective)

- 44705 (Preparation of fecal microbiota for instillation, including assessment of donor specimen)

- 44799 (Unlisted procedure, small intestine)

- J2315 (Injection, palonosetron HCl, 0.25 mg)

- J3590 (Unclassified biologics, may be used for fecal microbiota transplantation)

CPT code selection should be based on the specific services rendered and clinical documentation.

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