ICD-10 A48.51
Billable / Specific CCInfant botulism
About ICD-10-CM A48.51
ICD-10-CM code A48.51 represents Infant botulism. This is a billable/specific code in the Infectious and Parasitic Diseases chapter (block A48). The 2026 edition of ICD-10-CM A48.51 became effective on October 1, 2025.
Coding Tips for A48.51
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
A48.51 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 Infant botulism. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.
Medicare LCD Coverage for A48.51
Local Coverage Determinations (LCDs) from CMS MACs that list A48.51 as a covered diagnosis.
Showing top 10 of 66 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing A48.51.
2 Medicare
CPT Codes Commonly Billed with A48.51
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
- 0107T CMS LCD: Billing and Coding: Nerve Conduction Studies and Electromyography CMS LCD
- 0108T CMS LCD: Billing and Coding: Nerve Conduction Studies and Electromyography CMS LCD
- 0106T CMS LCD: Billing and Coding: Nerve Conduction Studies and Electromyography CMS LCD
- 0110T CMS LCD: Billing and Coding: Nerve Conduction Studies and Electromyography CMS LCD
- 0109T CMS LCD: Billing and Coding: Nerve Conduction Studies and Electromyography CMS LCD
- 51784 CMS LCD: Billing and Coding: Nerve Conduction Studies and Electromyography CMS LCD
Convert A48.51 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 |
|---|---|---|
| A48.51 | 04041 | 00000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To A48.51
Other codes in section A30-A49 (Other bacterial diseases).
ICD-10 A48.51, Billing FAQ
Is ICD-10 code A48.51 billable? +
Yes, A48.51 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
Is A48.51 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 A48.51? +
Procedures frequently paired with A48.51 include: 0107T, 0108T, 0106T, 0110T, 0109T.
What ICD-9 codes does A48.51 map to? +
Per CMS GEMs, A48.51 maps to ICD-9 codes: 04041. 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 18, 2026.
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