ICD-10 A54.1
Billable / Specific CCGonococcal infection of lower genitourinary tract with periurethral and accessory gland abscess
About ICD-10-CM A54.1
ICD-10-CM code A54.1 represents Gonococcal infection of lower genitourinary tract with periurethral and accessory gland abscess. This is a billable/specific code in the Infectious and Parasitic Diseases chapter (block A54). The 2026 edition of ICD-10-CM A54.1 became effective on October 1, 2025.
Coding Tips for A54.1
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
A54.1 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 A54.1. Per CMS ICD-10-CM Tabular 2026.
- Gonococcal Bartholin's gland abscess
Inpatient DRG Impact, CC
codes Gonococcal infection of lower genitourinary tract with periurethral and accessory gland abscess. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.
Medicare LCD Coverage for A54.1
Local Coverage Determinations (LCDs) from CMS MACs that list A54.1 as a covered diagnosis.
Showing top 10 of 588 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing A54.1.
5 Medicare
CPT Codes Commonly Billed with A54.1
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
- 54056 CMS LCD: Billing and Coding: Removal of Benign Skin Lesions CMS LCD
- 54050 CMS LCD: Billing and Coding: Removal of Benign Skin Lesions CMS LCD
- 54057 CMS LCD: Billing and Coding: Removal of Benign Skin Lesions CMS LCD
- 54065 CMS LCD: Billing and Coding: Removal of Benign Skin Lesions CMS LCD
- 54060 CMS LCD: Billing and Coding: Removal of Benign Skin Lesions CMS LCD
- 46916 CMS LCD: Billing and Coding: Removal of Benign Skin Lesions CMS LCD
- 54055 CMS LCD: Billing and Coding: Removal of Benign Skin Lesions CMS LCD
- 56515 CMS LCD: Billing and Coding: Removal of Benign Skin Lesions CMS LCD
- 46900 CMS LCD: Billing and Coding: Removal of Benign Skin Lesions CMS LCD
- 56501 CMS LCD: Billing and Coding: Removal of Benign Skin Lesions CMS LCD
Convert A54.1 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 |
|---|---|---|
| A54.1 | 0980 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To A54.1
Other codes in section A50-A64 (Infections with a predominantly sexual mode of transmission).
ICD-10 A54.1, Billing FAQ
Is ICD-10 code A54.1 billable? +
Yes, A54.1 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 A54.1? +
ICD-10 A54.1 includes: Gonococcal Bartholin's gland abscess.
Is A54.1 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 A54.1? +
Procedures frequently paired with A54.1 include: 54056, 54050, 54057, 54065, 54060.
What ICD-9 codes does A54.1 map to? +
Per CMS GEMs, A54.1 maps to ICD-9 codes: 0980. 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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