ICD Code B95.61

ICD code B95.61 is used to identify Methicillin susceptible Staphylococcus aureus (MSSA) infection as the underlying cause of diseases that are classified elsewhere in medical records. This code is typically used as a secondary code to provide additional information about the bacterial cause of an infection when MSSA is responsible. It helps healthcare providers and billing professionals accurately document and categorize the infection for treatment and reimbursement purposes.

1. Confirmed Presence of Staphylococcus aureus: The patient must have a laboratory-confirmed presence of Staphylococcus aureus in a clinical specimen, indicating an infection.

2. Susceptibility to Methicillin: The Staphylococcus aureus strain must be tested and confirmed to be susceptible to methicillin and other beta-lactam antibiotics.

3. Secondary Infection: The infection caused by methicillin-susceptible Staphylococcus aureus (MSSA) should be identified as a secondary infection contributing to or complicating another primary disease or condition.

4. Clinical Symptoms: The patient should exhibit clinical symptoms consistent with a Staphylococcus aureus infection, such as fever, localized pain, redness, swelling, or pus formation at the infection site.

5. Exclusion of Other Pathogens: Other potential pathogens should be ruled out as the primary cause of the symptoms, confirming that MSSA is the causative agent.

6. Documentation in Medical Records: The diagnosis and susceptibility of the Staphylococcus aureus strain should be clearly documented in the patient's medical records by the healthcare provider.

7. Treatment Plan: A treatment plan should be in place that targets the MSSA infection, often involving appropriate antibiotic therapy based on susceptibility testing.

By adhering to these criteria, healthcare providers can ensure accurate coding and effective management of infections caused by methicillin-susceptible Staphylococcus aureus.

For the ICD code B95.61, which indicates a Methicillin susceptible Staphylococcus aureus infection as the cause of diseases classified elsewhere, the relevant CPT codes would depend on the specific procedures or services provided to treat the condition. Here are some general categories of CPT codes that might be applicable:

1. Evaluation and Management (E/M) Codes: These codes are used for office visits, hospital visits, and consultations. Examples include:

  - 99201-99215 for office or other outpatient services

  - 99221-99239 for hospital inpatient services

2. Laboratory and Pathology Codes: If laboratory tests are conducted to diagnose or monitor the infection, relevant codes might include:

  - 87070-87075 for bacterial culture, aerobic

  - 87186 for susceptibility studies

3. Surgical Procedure Codes: If surgical intervention is required, such as incision and drainage of an abscess, relevant codes might include:

  - 10060-10061 for incision and drainage of abscess

4. Antibiotic Administration Codes: If antibiotics are administered, either orally or intravenously, relevant codes might include:

  - 96365-96368 for intravenous infusion for therapy, prophylaxis, or diagnosis

5. Radiology Codes: If imaging is required to assess the extent of the infection, relevant codes might include:

  - 71045-71048 for chest X-ray

  - 73721-73723 for MRI of the lower extremity

It is important to note that the selection of CPT codes should be based on the specific services provided and documented in the patient's medical record. Always ensure coding accuracy by consulting the latest CPT code set and guidelines.

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