B95-B97
Bacterial and viral infectious agents
Block coding notes
Excludes 1 never together · Excludes 2 may co-exist
Note
These categories are provided for use as supplementary or additional codes to identify the infectious agent(s) in diseases classified elsewhere.
Codes in this block
56 codes
Billableusable codeNon-billableheader / grouping codeRisk-adjusting
- B95Streptococcus, Staphylococcus, and Enterococcus as the cause of diseases classified elsewhereNon-billable
- B95.0Streptococcus, group A, as the cause of diseases classified elsewhereBillable
- B95.1Streptococcus, group B, as the cause of diseases classified elsewhereBillable
- B95.2Enterococcus as the cause of diseases classified elsewhereBillable
- B95.3Streptococcus pneumoniae as the cause of diseases classified elsewhereBillable
- B95.4Other streptococcus as the cause of diseases classified elsewhereBillable
- B95.5Unspecified streptococcus as the cause of diseases classified elsewhereBillable
- B95.6Staphylococcus aureus as the cause of diseases classified elsewhereNon-billable
- B95.61Methicillin susceptible Staphylococcus aureus infection as the cause of diseases classified elsewhereBillable
- B95.62Methicillin resistant Staphylococcus aureus infection as the cause of diseases classified elsewhereBillable
- B95.7Other staphylococcus as the cause of diseases classified elsewhereBillable
- B95.8Unspecified staphylococcus as the cause of diseases classified elsewhereBillable
- B96Other bacterial agents as the cause of diseases classified elsewhereNon-billable
- B96.0Mycoplasma pneumoniae [M. pneumoniae] as the cause of diseases classified elsewhereBillable
- B96.1Klebsiella pneumoniae [K. pneumoniae] as the cause of diseases classified elsewhereBillable
- B96.2Escherichia coli [E. coli ] as the cause of diseases classified elsewhereNon-billable
- B96.20Unspecified Escherichia coli [E. coli] as the cause of diseases classified elsewhereBillable
- B96.21Shiga toxin-producing Escherichia coli [E. coli] [STEC] O157 as the cause of diseases classified elsewhereBillable
- B96.22Other specified Shiga toxin-producing Escherichia coli [E. coli] [STEC] as the cause of diseases classified elsewhereBillable
- B96.23Unspecified Shiga toxin-producing Escherichia coli [E. coli] [STEC] as the cause of diseases classified elsewhereBillable
- B96.29Other Escherichia coli [E. coli] as the cause of diseases classified elsewhereBillable
- B96.3Hemophilus influenzae [H. influenzae] as the cause of diseases classified elsewhereBillable
- B96.4Proteus (mirabilis) (morganii) as the cause of diseases classified elsewhereBillable
- B96.5Pseudomonas (aeruginosa) (mallei) (pseudomallei) as the cause of diseases classified elsewhereBillable
- B96.6Bacteroides fragilis [B. fragilis] as the cause of diseases classified elsewhereBillable
- B96.7Clostridium perfringens [C. perfringens] as the cause of diseases classified elsewhereBillable
- B96.8Other specified bacterial agents as the cause of diseases classified elsewhereNon-billable
- B96.81Helicobacter pylori [H. pylori] as the cause of diseases classified elsewhereBillable
- B96.82Vibrio vulnificus as the cause of diseases classified elsewhereBillable
- B96.83Acinetobacter baumannii as the cause of diseases classified elsewhereBillable
- B96.89Other specified bacterial agents as the cause of diseases classified elsewhereBillable
- B97Viral agents as the cause of diseases classified elsewhereNon-billable
- B97.0Adenovirus as the cause of diseases classified elsewhereBillable
- B97.1Enterovirus as the cause of diseases classified elsewhereNon-billable
- B97.10Unspecified enterovirus as the cause of diseases classified elsewhereBillable
- B97.11Coxsackievirus as the cause of diseases classified elsewhereBillable
- B97.12Echovirus as the cause of diseases classified elsewhereBillable
- B97.19Other enterovirus as the cause of diseases classified elsewhereBillable
- B97.2Coronavirus as the cause of diseases classified elsewhereNon-billable
- B97.21SARS-associated coronavirus as the cause of diseases classified elsewhereBillable
- B97.29Other coronavirus as the cause of diseases classified elsewhereBillable
- B97.3Retrovirus as the cause of diseases classified elsewhereNon-billable
- B97.30Unspecified retrovirus as the cause of diseases classified elsewhereBillable
- B97.31Lentivirus as the cause of diseases classified elsewhereBillable
- B97.32Oncovirus as the cause of diseases classified elsewhereBillable
- B97.33Human T-cell lymphotrophic virus, type I [HTLV-I] as the cause of diseases classified elsewhereBillable
- B97.34Human T-cell lymphotrophic virus, type II [HTLV-II] as the cause of diseases classified elsewhereBillable
- B97.35Human immunodeficiency virus, type 2 [HIV 2] as the cause of diseases classified elsewhereBillable
- B97.39Other retrovirus as the cause of diseases classified elsewhereBillable
- B97.4Respiratory syncytial virus as the cause of diseases classified elsewhereBillable
- B97.5Reovirus as the cause of diseases classified elsewhereBillable
- B97.6Parvovirus as the cause of diseases classified elsewhereBillable
- B97.7Papillomavirus as the cause of diseases classified elsewhereBillable
- B97.8Other viral agents as the cause of diseases classified elsewhereNon-billable
- B97.81Human metapneumovirus as the cause of diseases classified elsewhereBillable
- B97.89Other viral agents as the cause of diseases classified elsewhereBillable
Official Guidelines for B95-B97
FY 2026 ›I.C.1Chapter-specific guidanceChapter 1: Certain Infectious and Parasitic Diseases (A00-B99), U07.1, U09.9
Subsections
- I.C.1.aHuman Immunodeficiency Virus (HIV) Infections
- I.C.1.bInfectious agents as the cause of diseases classified to other chapters
- I.C.1.cInfections resistant to antibiotics
- I.C.1.dSepsis, Severe Sepsis, and Septic Shock Infections resistant to antibiotics
- I.C.1.eMethicillin Resistant Staphylococcus aureus (MRSA) Conditions
- I.C.1.fZika virus infections
- I.C.1.gCoronavirus infections
Sections that reference codes in B95-B97
- I.B.7Multiple coding for a single conditionB95General rules
- I.C.1.bInfectious agents as the cause of diseases classified to other chaptersB95
- I.C.1.e.1)(a)Combination codes for MRSA infectionB95.62
- I.C.1.e.1)(b)Other codes for MRSA infectionB95.62
- I.C.10.d.1)Documentation of Ventilator associated PneumoniaB96.5Chapter 10 guidance
- I.C.15.kPuerperal sepsisB95-B96Chapter 15 guidance
- I.C.16.fBacterial Sepsis of NewbornB95Chapter 16 guidance