ICD-10 A04.6
Billable / Specific CCEnteritis due to Yersinia enterocolitica
About ICD-10-CM A04.6
ICD-10-CM code A04.6 represents Enteritis due to Yersinia enterocolitica. This is a billable/specific code in the Infectious and Parasitic Diseases chapter (block A04). The 2026 edition of ICD-10-CM A04.6 became effective on October 1, 2025.
Coding Tips for A04.6
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
A04.6 is designated CC for MS-DRG grouping. On inpatient claims, this code can shift the DRG to the with-CC variant when documented as a present-on-admission secondary diagnosis. Hospital CDI programs flag CC opportunities during chart review. Failure to capture this code may leave 30 to 80 percent of the inpatient stay revenue unrealized.
Type 1 Excludes
Pure excludes, these codes can never be coded together with A04.6. The conditions are mutually exclusive (e.g., congenital vs acquired forms).
- extraintestinal yersiniosis (A28.2)
Inpatient DRG Impact, CC
codes Enteritis due to Yersinia enterocolitica. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.
Medicare LCD Coverage for A04.6
Local Coverage Determinations (LCDs) from CMS MACs that list A04.6 as a covered diagnosis.
Showing top 10 of 635 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing A04.6.
5 Medicare
CPT Codes Commonly Billed with A04.6
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
- 87482 CMS LCD: Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing CMS LCD
- 0429U CMS LCD: Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing CMS LCD
- 87557 CMS LCD: Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing CMS LCD
- 87593 CMS LCD: Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing CMS LCD
- 0068U CMS LCD: Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing CMS LCD
- 87651 CMS LCD: Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing CMS LCD
- 87487 CMS LCD: Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing CMS LCD
- 87538 CMS LCD: Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing CMS LCD
- 87563 CMS LCD: Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing CMS LCD
- 87582 CMS LCD: Billing and Coding: MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing CMS LCD
Convert A04.6 to ICD-9-CM
Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.
| ICD-10 | ICD-9 | Mapping Flags |
|---|---|---|
| A04.6 | 00844 | 00000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To A04.6
Other codes in section A00-A09 (Intestinal infectious diseases).
ICD-10 A04.6, Billing FAQ
Is ICD-10 code A04.6 billable? +
Yes, A04.6 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
What codes are Type 1 Excludes for A04.6? +
Type 1 Excludes (never code together with A04.6): extraintestinal yersiniosis (A28.2)
Is A04.6 a CC or MCC for inpatient DRG? +
Yes, this code is designated as CC. Documenting as a secondary diagnosis on inpatient claims can shift the DRG to a higher-weighted category.
What CPT codes are commonly billed with A04.6? +
Procedures frequently paired with A04.6 include: 87482, 0429U, 87557, 87593, 0068U.
What ICD-9 codes does A04.6 map to? +
Per CMS GEMs, A04.6 maps to ICD-9 codes: 00844. Useful for legacy data review and historical claim analysis.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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