ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 B95.1

Billable / Specific

Streptococcus, group B, as the cause of diseases classified elsewhere

B95
Block
0
Synonyms
78
LCDs
2
Payer Policies
11
Linked CPTs

About ICD-10-CM B95.1

ICD-10-CM code B95.1 represents Streptococcus, group B, as the cause of diseases classified elsewhere. This is a billable/specific code in the Infectious and Parasitic Diseases chapter (block B95). The 2026 edition of ICD-10-CM B95.1 became effective on October 1, 2025.

Medicare LCD Coverage for B95.1

Local Coverage Determinations (LCDs) from CMS MACs that list B95.1 as a covered diagnosis.

78 LCDs

Showing top 10 of 78 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Colonoscopy and Sigmoidoscopy-Diagnostic
Article ID: 56394, Effective: 2025-01-01 00:00:00, 319 covered, 0 non-covered
CPT 45341 →
CMS LCD: Billing and Coding: Colonoscopy and Sigmoidoscopy-Diagnostic
Article ID: 56394, Effective: 2025-01-01 00:00:00, 319 covered, 0 non-covered
CPT 45331 →
CMS LCD: Billing and Coding: Colonoscopy and Sigmoidoscopy-Diagnostic
Article ID: 56394, Effective: 2025-01-01 00:00:00, 319 covered, 0 non-covered
CPT 44392 →
CMS LCD: Billing and Coding: Colonoscopy and Sigmoidoscopy-Diagnostic
Article ID: 56394, Effective: 2025-01-01 00:00:00, 319 covered, 0 non-covered
CPT 45386 →
CMS LCD: Billing and Coding: Colonoscopy and Sigmoidoscopy-Diagnostic
Article ID: 56394, Effective: 2025-01-01 00:00:00, 319 covered, 0 non-covered
CPT 45378 →
CMS LCD: Billing and Coding: Colonoscopy and Sigmoidoscopy-Diagnostic
Article ID: 56394, Effective: 2025-01-01 00:00:00, 319 covered, 0 non-covered
CPT 44390 →
CMS LCD: Billing and Coding: Colonoscopy and Sigmoidoscopy-Diagnostic
Article ID: 56394, Effective: 2025-01-01 00:00:00, 319 covered, 0 non-covered
CPT 44394 →
CMS LCD: Billing and Coding: Colonoscopy and Sigmoidoscopy-Diagnostic
Article ID: 56394, Effective: 2025-01-01 00:00:00, 319 covered, 0 non-covered
CPT 45332 →
CMS LCD: Billing and Coding: Colonoscopy and Sigmoidoscopy-Diagnostic
Article ID: 56394, Effective: 2025-01-01 00:00:00, 319 covered, 0 non-covered
CPT 45338 →
CMS LCD: Billing and Coding: Colonoscopy and Sigmoidoscopy-Diagnostic
Article ID: 56394, Effective: 2025-01-01 00:00:00, 319 covered, 0 non-covered
CPT 45342 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing B95.1.

2 policies

2 Medicare

Billing and Coding: Colonoscopy and Sigmoidoscopy-Diagnostic
Policy ID: ART-56394
Billing and Coding: Plastic Surgery
Policy ID: ART-57221

CPT Codes Commonly Billed with B95.1

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

11 linkages
  • 45341 CMS LCD: Billing and Coding: Colonoscopy and Sigmoidoscopy-Diagnostic CMS LCD
  • 45331 CMS LCD: Billing and Coding: Colonoscopy and Sigmoidoscopy-Diagnostic CMS LCD
  • 45337 CMS LCD: Billing and Coding: Colonoscopy and Sigmoidoscopy-Diagnostic CMS LCD
  • 45332 CMS LCD: Billing and Coding: Colonoscopy and Sigmoidoscopy-Diagnostic CMS LCD
  • 45334 CMS LCD: Billing and Coding: Colonoscopy and Sigmoidoscopy-Diagnostic CMS LCD
  • 45335 CMS LCD: Billing and Coding: Colonoscopy and Sigmoidoscopy-Diagnostic CMS LCD
  • 45342 CMS LCD: Billing and Coding: Colonoscopy and Sigmoidoscopy-Diagnostic CMS LCD
  • 45330 CMS LCD: Billing and Coding: Colonoscopy and Sigmoidoscopy-Diagnostic CMS LCD
  • 45338 CMS LCD: Billing and Coding: Colonoscopy and Sigmoidoscopy-Diagnostic CMS LCD
  • 45333 CMS LCD: Billing and Coding: Colonoscopy and Sigmoidoscopy-Diagnostic CMS LCD

Convert B95.1 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
B95.1 04102 00000

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

Codes Adjacent To B95.1

Other codes in section B95-B97 (Bacterial and viral infectious agents).

B95 Streptococcus, Staphylococcus, and Enterococcus as the cause of diseases classified elsewhere (non-billable) B95.0 Streptococcus, group A, as the cause of diseases classified elsewhere B95.2 Enterococcus as the cause of diseases classified elsewhere B95.3 Streptococcus pneumoniae as the cause of diseases classified elsewhere B95.4 Other streptococcus as the cause of diseases classified elsewhere B95.5 Unspecified streptococcus as the cause of diseases classified elsewhere B95.6 Staphylococcus aureus as the cause of diseases classified elsewhere (non-billable) B95.61 Methicillin susceptible Staphylococcus aureus infection as the cause of diseases classified elsewhere B95.62 Methicillin resistant Staphylococcus aureus infection as the cause of diseases classified elsewhere B95.7 Other staphylococcus as the cause of diseases classified elsewhere B95.8 Unspecified staphylococcus as the cause of diseases classified elsewhere B96 Other bacterial agents as the cause of diseases classified elsewhere (non-billable) B96.0 Mycoplasma pneumoniae [M. pneumoniae] as the cause of diseases classified elsewhere B96.1 Klebsiella pneumoniae [K. pneumoniae] as the cause of diseases classified elsewhere B96.2 Escherichia coli [E. coli ] as the cause of diseases classified elsewhere (non-billable) B96.20 Unspecified Escherichia coli [E. coli] as the cause of diseases classified elsewhere B96.21 Shiga toxin-producing Escherichia coli [E. coli] [STEC] O157 as the cause of diseases classified elsewhere B96.22 Other specified Shiga toxin-producing Escherichia coli [E. coli] [STEC] as the cause of diseases classified elsewhere B96.23 Unspecified Shiga toxin-producing Escherichia coli [E. coli] [STEC] as the cause of diseases classified elsewhere B96.29 Other Escherichia coli [E. coli] as the cause of diseases classified elsewhere

ICD-10 B95.1, Billing FAQ

Is ICD-10 code B95.1 billable? +

Yes, B95.1 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What CPT codes are commonly billed with B95.1? +

Procedures frequently paired with B95.1 include: 45341, 45331, 45337, 45332, 45334.

What ICD-9 codes does B95.1 map to? +

Per CMS GEMs, B95.1 maps to ICD-9 codes: 04102. 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 June 1, 2026.

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