ICD-10 A52.16
Billable / Specific CCCharcot's arthropathy (tabetic)
About ICD-10-CM A52.16
ICD-10-CM code A52.16 represents Charcot's arthropathy (tabetic). This is a billable/specific code in the Infectious and Parasitic Diseases chapter (block A52). The 2026 edition of ICD-10-CM A52.16 became effective on October 1, 2025.
Coding Tips for A52.16
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
A52.16 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 Charcot's arthropathy (tabetic). As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.
Medicare LCD Coverage for A52.16
Local Coverage Determinations (LCDs) from CMS MACs that list A52.16 as a covered diagnosis.
Showing top 10 of 218 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing A52.16.
5 Medicare
CPT Codes Commonly Billed with A52.16
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
- 11719 CMS LCD: Billing and Coding: Routine Foot Care and Debridement of Nails CMS LCD
- G0127 CMS LCD: Billing and Coding: Routine Foot Care and Debridement of Nails CMS LCD
- 11056 CMS LCD: Billing and Coding: Routine Foot Care and Debridement of Nails CMS LCD
- 97168 CMS LCD: Billing and Coding: Outpatient Occupational Therapy CMS LCD
- 97166 CMS LCD: Billing and Coding: Outpatient Occupational Therapy CMS LCD
- 92626 CMS LCD: Billing and Coding: Outpatient Occupational Therapy CMS LCD
- 29086 CMS LCD: Billing and Coding: Outpatient Occupational Therapy CMS LCD
- 92627 CMS LCD: Billing and Coding: Outpatient Occupational Therapy CMS LCD
- 97165 CMS LCD: Billing and Coding: Outpatient Occupational Therapy CMS LCD
- 92610 CMS LCD: Billing and Coding: Outpatient Occupational Therapy CMS LCD
Convert A52.16 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 |
|---|---|---|
| A52.16 | 0940 | 10111 |
| A52.16 | 7135 | 10112 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To A52.16
Other codes in section A50-A64 (Infections with a predominantly sexual mode of transmission).
ICD-10 A52.16, Billing FAQ
Is ICD-10 code A52.16 billable? +
Yes, A52.16 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
Is A52.16 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 A52.16? +
Procedures frequently paired with A52.16 include: 11719, G0127, 11056, 97168, 97166.
What ICD-9 codes does A52.16 map to? +
Per CMS GEMs, A52.16 maps to ICD-9 codes: 0940, 7135. 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 16, 2026.
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