Cracking the Code

Coding MRSA

MRSA is any strain of Staphylococcus aureus that has developed a resistance to antibiotics. It is a difficult infection to treat. Our ICD-10-CM guidelines layout coding MRSA under different circumstances. There are combination codes that report the infection and the causal agent. For example, a patient with pneumonia due to Methicillin-resistant Staphylococcus aureus is reported with combination code J15.212. If there is not a combination code, report a code for the condition and B95.62 Methicillin-resistant Staphylococcus aureus infection as the cause of diseases classified elsewhere. Do not assign Z16.11, Resistance to penicillin, as an additional diagnosis.

If the patient is a carrier of MRSA and does not have an active infection, report code Z22.322 Carrier or suspected carrier of Methicillin-resistant Staphylococcus aureus. A personal history of MRSA, with no mention of colonization, should be reported with Z86.14.

Q: What is the correct code sequence for a patient with a history of MRSA who is scheduled for a right hip replacement to treat osteoarthritis of her hip?
A: M16.11, Z86.14. Rationale: Osteoarthritis is found in our ICD-10-CM codebooks and in the Alphabetic Index by looking for Osteoarthritis/hip M16.1-. In the Tabular List, M16.11 is reported for osteoarthritis of the right hip. Personal history of MRSA is found in the Alphabetic Index by looking at History/personal (of)/Methicillin-resistant Staphylococcus aureus (MRSA) Z86.14. As always, we want to verify all codes in the Tabular List.
Reference: FY 2023 ICD-10-CM Guidelines
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