ICD-10 A48.5
Non-Billable HeaderOther specified botulism
About ICD-10-CM A48.5
ICD-10-CM code A48.5 represents Other specified botulism. This is a non-billable header code in the Infectious and Parasitic Diseases chapter (block A48). The 2026 edition of ICD-10-CM A48.5 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 A48.5. Per CMS ICD-10-CM Tabular 2026.
- Non-foodborne intoxication due to toxins of Clostridium botulinum [C. botulinum]
Type 1 Excludes
Pure excludes, these codes can never be coded together with A48.5. The conditions are mutually exclusive (e.g., congenital vs acquired forms).
- food poisoning due to toxins of Clostridium botulinum (A05.1)
Medicare LCD Coverage for A48.5
Local Coverage Determinations (LCDs) from CMS MACs that list A48.5 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 A48.5.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but A48.5 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
CPT Codes Commonly Billed with A48.5
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 A48.5
Other codes in section A30-A49 (Other bacterial diseases).
ICD-10 A48.5, Billing FAQ
Is ICD-10 code A48.5 billable? +
No, A48.5 is a non-billable header code. Use a more specific child code from block A48 when submitting claims.
What other names or terms map to A48.5? +
ICD-10 A48.5 includes: Non-foodborne intoxication due to toxins of Clostridium botulinum [C. botulinum].
What codes are Type 1 Excludes for A48.5? +
Type 1 Excludes (never code together with A48.5): food poisoning due to toxins of Clostridium botulinum (A05.1)
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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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