ICD-10 A05.4
Billable / Specific CCFoodborne Bacillus cereus intoxication
About ICD-10-CM A05.4
ICD-10-CM code A05.4 represents Foodborne Bacillus cereus intoxication. This is a billable/specific code in the Infectious and Parasitic Diseases chapter (block A05). The 2026 edition of ICD-10-CM A05.4 became effective on October 1, 2025.
Coding Tips for A05.4
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
A05.4 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.
Inpatient DRG Impact, CC
codes Foodborne Bacillus cereus intoxication. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.
Medicare LCD Coverage for A05.4
Local Coverage Determinations (LCDs) from CMS MACs that list A05.4 as a covered diagnosis.
Showing top 10 of 565 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing A05.4.
5 Medicare
CPT Codes Commonly Billed with A05.4
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 A05.4 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 |
|---|---|---|
| A05.4 | 00589 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To A05.4
Other codes in section A00-A09 (Intestinal infectious diseases).
ICD-10 A05.4, Billing FAQ
Is ICD-10 code A05.4 billable? +
Yes, A05.4 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
Is A05.4 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 A05.4? +
Procedures frequently paired with A05.4 include: 87482, 0429U, 87557, 87593, 0068U.
What ICD-9 codes does A05.4 map to? +
Per CMS GEMs, A05.4 maps to ICD-9 codes: 00589. 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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