B96.81-icd-10 code for helicobacter pylori

The International Classification of Diseases, 10th Revision (ICD-10), is an essential system used worldwide to classify and code various diseases, conditions, and health-related issues. Among its extensive repertoire of codes, B96.81 stands out as a significant identifier for a specific bacterial infection: Helicobacter pylori. The B96.81-ICD-10 code for Helicobacter pylori has emerged as an indispensable tool for medical professionals, offering a streamlined approach to diagnose and classify infections related to this enigmatic bacterium. Unraveling the complexities of this code and its implications for healthcare practitioners is crucial, which is why many of them are turning to specialized medical coding companies to navigate the intricacies of B96.81. MedsIT Nexus Medical Coding Services are acing for this type of coding due to experienced and skilled coders.
This article delves into the enigmatic world of Helicobacter pylori code B96.81, some significant conditions associated with it, and its DRGs.

ICD-10-CM Code for Helicobacter pylori (H. pylori) as the cause of diseases classified elsewhere B96.81

B96.81 is a valid, billable, and specific ICD-10-CM code used to diagnose and seek reimbursement in medical settings for H. pylori as the cause of a disease classified somewhere else. This code indicates that Helicobacter pylori is a gram-negative bacteria that colonizes the human gastric mucosa causing GIT diseases) is the causative factor for various diseases classified elsewhere, which means it is employed to identify conditions in which H. Pylori is responsible for causing or complicating other diseases. The effective date of the 2023 edition of ICD-10-CM B96.81 was October 1, 2022, and it is intended for use in HIPAA-covered transactions. It is important to note that this code represents a circumstance that influences the patient's health rather than a current illness or injury.
A significant concern about this code is “Can B96.81 be a primary diagnosis?" According to the ICD-10 system, it is not acceptable to be used as the principal diagnosis. In the ICD-10 coding system, under codes B95-B97, it is indicated that these categories are meant to be used as additional codes rather than primary diagnoses. They aim to help identify the specific infectious agent(s) responsible for a disease already classified elsewhere. Therefore, you would not use a code like B96.81 as the primary diagnosis but rather as a supplementary code along with the primary disease code.

Code classification

Chapter (A00-B99) - Certain infectious and parasitic diseases
Category (B95-B97) - Bacterial and viral infectious agents
Subcategory (B96) - Other bacterial agents as the cause of diseases classified elsewhere
Parent code (B96.8) - Other specified bacterial agents as the cause of diseases classified elsewhere
Specific code (B96.81) - Helicobacter pylori [H. pylori] as the cause of diseases classified elsewhere
Code B96.81 falls under Chapter 1 of the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM). It belongs to the "Infections with a predominantly sexual mode of transmission" category. This classification highlights that H. pylori infection is primarily transmitted through oral-oral or fecal-oral routes, making it essential to identify and code accurately to facilitate proper treatment and containment of the infection.

Clinical information

H. pylori was discovered in 1982, and in the U.S., around 36% of people have an infection of the stomach due to H. pylori. It is unique as it can survive in the stomach's acidic environment by producing the enzyme urease, which leads to diseases, even gastric cancer.
Gastritis: Inflammation of the stomach lining can lead to abdominal pain, bloating, and discomfort.
Nausea and vomiting: Some individuals with H. pylori infection may experience episodes of nausea and vomiting.
Indigestion: It can cause discomfort in the upper abdomen and indigestion.
Anemia: Chronic H. Pylori infection can result in iron deficiency anemia due to bleeding from peptic Ulcer.

MS-DRG Mapping

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Related codes browser

B96.82: Vibrio vulnificus as the significant cause/reason of diseases classified elsewhere
B96.89: Other specified bacterial agents as the significant reason/cause of diseases classified elsewhere
B96.0: Mycoplasma pneumonia is the cause of diseases classified elsewhere
B96.2: E. coli as the significant reason/cause of diseases classified elsewhere
B96.4: Proteus (mirabilis) (morganii) as the cause of diseases classified elsewhere
B96.6: Bacillus fragilis as the cause of diseases classified elsewhere

Other conditions associated with H. pylori and their codes

Code B96.81 is used in conjunction with primary diagnosis codes to convey the association between H. pylori infection and other medical conditions. Some of the relevant conditions where this code might be used include but are not limited to:
Peptic Ulcer, unspecified (K25.9)
Peptic ulcers, coded as K25.9 in the ICD-10 system, is a condition intricately linked to H. pylori infection. The bacterium's virulence factors play a significant role in developing these ulcers, causing erosions in the mucosal lining of the stomach or duodenum, leading to pain and potential complications.
Gastric MALT Lymphoma (C88.4)
The association between H. pylori and Mucosa-Associated Lymphoid Tissue (MALT) lymphoma is well-established. The B96.81 code may account for this unique condition (C88.4), where H. pylori-induced chronic inflammation triggers lymphoma development.
Functional Dyspepsia (K30)
Dyspepsia, coded as K30, represents a condition marked by upper abdominal discomfort or pain. While the correlation between H. pylori and dyspepsia remains a subject of ongoing research, the bacterium's presence may contribute to this vexing symptomatology.
Gastrointestinal Bleeding (K92.0, K92.2)
H. pylori infection may lead to gastrointestinal bleeding, warranting codes K92.0 (hematemesis) and K92.2 (gastrointestinal hemorrhage, unspecified).
Stomach Cancer (C16)
Persistent H. pylori infection has been identified as a prominent risk factor for developing stomach cancer, also known as gastric cancer. The ICD-10 code for stomach cancer is C16, with specific codes for different stomach regions and various histological types.
For example:
C16.0 – Malignancy of cardia of the stomach
C16.1 - Malignant Cancer of the fundus of the stomach
C16.2 - Malignant cancer of the body of the stomach
C16.3 - Malignant cancer of pyloric antrum
C16.4 - Malignant cancer of pylorus
C16.5 - Malignant cancer of lesser curvature of the stomach, unspecified
C16.6 - Malignant cancer of greater curvature of the stomach, unspecific C16.8 - Malignant cancer of overlapping sites of stomach
C16.9 - Malignant cancer of the stomach, unspecified

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