ICD-10 A04.7
Non-Billable HeaderEnterocolitis due to Clostridium difficile
About ICD-10-CM A04.7
ICD-10-CM code A04.7 represents Enterocolitis due to Clostridium difficile. This is a non-billable header code in the Infectious and Parasitic Diseases chapter (block A04). The 2026 edition of ICD-10-CM A04.7 became effective on October 1, 2025. Non-billable codes cannot be used as a primary or secondary diagnosis on a claim, use a more specific child code instead.
Inclusion Terms / Approximate Synonyms
Clinical terms and conditions classified under A04.7. Per CMS ICD-10-CM Tabular 2026.
- Clostridioides difficile colitis
- Foodborne intoxication by Clostridium difficile
- Pseudomembraneous colitis
Medicare LCD Coverage for A04.7
Local Coverage Determinations (LCDs) from CMS MACs that list A04.7 as a covered diagnosis.
This doesn't mean the code isn't covered, it means no MAC has issued a Local Coverage Determination naming this specific code. Coverage may still apply under National Coverage Determinations or general medical-necessity rules.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing A04.7.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but A04.7 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
CPT Codes Commonly Billed with A04.7
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.
Convert A04.7 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 |
|---|---|---|
| A04.7 | 00845 | 00000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To A04.7
Other codes in section A00-A09 (Intestinal infectious diseases).
ICD-10 A04.7, Billing FAQ
Is ICD-10 code A04.7 billable? +
No, A04.7 is a non-billable header code. Use a more specific child code from block A04 when submitting claims.
What other names or terms map to A04.7? +
ICD-10 A04.7 includes: Clostridioides difficile colitis; Foodborne intoxication by Clostridium difficile; Pseudomembraneous colitis.
What ICD-9 codes does A04.7 map to? +
Per CMS GEMs, A04.7 maps to ICD-9 codes: 00845. 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 July 16, 2026.
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