ICD-10 A38
Non-Billable HeaderScarlet fever
About ICD-10-CM A38
ICD-10-CM code A38 represents Scarlet fever. This is a non-billable header code in the Infectious and Parasitic Diseases chapter (block A38). The 2026 edition of ICD-10-CM A38 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.
Type 2 Excludes
Not included here, the excluded code is not part of A38, but a patient may have both conditions at the same time. Both codes may be coded together when applicable.
- streptococcal sore throat (J02.0)
Includes
- scarlatina
Medicare LCD Coverage for A38
Local Coverage Determinations (LCDs) from CMS MACs that list A38 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 A38.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but A38 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
CPT Codes Commonly Billed with A38
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.
Codes Adjacent To A38
Other codes in section A30-A49 (Other bacterial diseases).
ICD-10 A38, Billing FAQ
Is ICD-10 code A38 billable? +
No, A38 is a non-billable header code. Use a more specific child code from block A38 when submitting claims.
What codes are Type 2 Excludes for A38? +
Type 2 Excludes (may be coded together when both conditions exist): streptococcal sore throat (J02.0)
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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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