ICD-10 A36.89
Billable / Specific CCOther diphtheritic complications
About ICD-10-CM A36.89
ICD-10-CM code A36.89 represents Other diphtheritic complications. This is a billable/specific code in the Infectious and Parasitic Diseases chapter (block A36). The 2026 edition of ICD-10-CM A36.89 became effective on October 1, 2025.
Coding Tips for A36.89
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
A36.89 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.
Inclusion Terms / Approximate Synonyms
Clinical terms and conditions classified under A36.89. Per CMS ICD-10-CM Tabular 2026.
- Diphtheritic peritonitis
Inpatient DRG Impact, CC
codes Other diphtheritic complications. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.
Medicare LCD Coverage for A36.89
Local Coverage Determinations (LCDs) from CMS MACs that list A36.89 as a covered diagnosis.
Showing top 10 of 46 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing A36.89.
1 Medicare
CPT Codes Commonly Billed with A36.89
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
- 90750 CMS LCD: Billing and Coding: Immunizations CMS LCD
- 90587 CMS LCD: Billing and Coding: Immunizations CMS LCD
- 90680 CMS LCD: Billing and Coding: Immunizations CMS LCD
- 90651 CMS LCD: Billing and Coding: Immunizations CMS LCD
- 90690 CMS LCD: Billing and Coding: Immunizations CMS LCD
- 90296 CMS LCD: Billing and Coding: Immunizations CMS LCD
- 90650 CMS LCD: Billing and Coding: Immunizations CMS LCD
- 90477 CMS LCD: Billing and Coding: Immunizations CMS LCD
- 90619 CMS LCD: Billing and Coding: Immunizations CMS LCD
- 90738 CMS LCD: Billing and Coding: Immunizations CMS LCD
Convert A36.89 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 |
|---|---|---|
| A36.89 | 0322 | 10000 |
| A36.89 | 03283 | 10000 |
| A36.89 | 03289 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To A36.89
Other codes in section A30-A49 (Other bacterial diseases).
ICD-10 A36.89, Billing FAQ
Is ICD-10 code A36.89 billable? +
Yes, A36.89 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
What other names or terms map to A36.89? +
ICD-10 A36.89 includes: Diphtheritic peritonitis.
Is A36.89 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 A36.89? +
Procedures frequently paired with A36.89 include: 90750, 90587, 90680, 90651, 90690.
What ICD-9 codes does A36.89 map to? +
Per CMS GEMs, A36.89 maps to ICD-9 codes: 0322, 03283, 03289. 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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