ICD Code A40.3

ICD code A40.3 is sepsis caused by Streptococcus pneumoniae, a type of bacteria that can lead to a severe, body-wide infection.

1. Clinical evidence of sepsis, including signs such as fever, chills, tachycardia, tachypnea, hypotension, or altered mental status

2. Laboratory confirmation of Streptococcus pneumoniae as the causative organism (e.g., positive blood cultures, PCR, or other microbiological testing)

3. Presence of systemic inflammatory response syndrome (SIRS) criteria, such as abnormal white blood cell count, elevated or decreased temperature, increased heart rate, or increased respiratory rate

4. Evidence of organ dysfunction attributable to the infectious process (e.g., acute kidney injury, respiratory distress, coagulopathy, or hepatic dysfunction)

5. Exclusion of other pathogens as the primary cause of sepsis

Relevant CPT codes that may be used to treat ICD code A40.3 include:

- 99221–99223 (Initial hospital care, per day, for the evaluation and management of a patient)

- 99231–99233 (Subsequent hospital care, per day, for the evaluation and management of a patient)

- 36415 (Collection of venous blood by venipuncture)

- 87040 (Blood culture for bacteria, aerobic)

- 96365–96366 (Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial and each additional hour)

- 96372 (Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular)

- 90772 (Therapeutic, prophylactic, or diagnostic injection, unspecified)

- 99291–99292 (Critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes, each additional 30 minutes)

- 99460–99462 (Initial hospital or intensive care, per day, for evaluation and management of the neonate)

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

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