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Help with Sepsis Proteus Mirabilis Due To UTI

  1. #1
    Question Help with Sepsis Proteus Mirabilis Due To UTI
    Medical Coding Books
    I do not know how to code for sepsis Proteus Mirabilis due to a UTI. How do I code for this???

    I did look up some codes in the ICD-10-CM book, but all I could find for Proteus Mirabilis was B96.4. This code does not include the sepsis. I am so confused because Proteus Mirabilis is a gram-negative, anaroebic bacteria. Does this mean I use a code for sepsis due to anaerobes (A41.4) for the sepsis? Or do I use A41.89 (other specified sepsis) for the sepsis? Or do I simply use the B96.4 code? Thank you in advance for any suggestions!

  2. #2
    How about A41.59 other gram negative sepsis with N39.0 UTI?

  3. #3
    Talking Codes Finally Used
    Thank you for your suggestion! It helped me get started on the right track.

    I finally decided to use 3 codes. For the sepsis, I am using A41.59 (Other Gram-Negative sepsis). For the Proteus Mirabilis, I am using B96.4 (Proteus as the cause of diseases classified elsewhere). For the UTI, I am using N39.0.

  4. #4
    I don't think you need B96.4. Below is a link for an article about coding Sepsis that I've found helpful.

  5. #5
    Question Explanation Please
    Would you please explain to me why you believe it is not necessary to use the B96.4 code? Thank you.

  6. #6
    The organism is included in the sepsis code A41.59

  7. #7
    Columbia, MO
    If you look in your guidelines for Sepsis it states:
    (a) Sepsis
    For a diagnosis of sepsis, assign the appropriate code for the underlying systemic infection. If the type of infection or causal organism is not further specified, assign code A41.9, Sepsis, unspecified organism.

    The Proteus is the underlying infection.

    Also there is a note with the A41 category indicating that other codes should be coded first. In other words A41 codes are secondary only.
    Use the B96.4 followed by the A41.4 then the N39.0

    Debra A. Mitchell, MSPH, CPC-H

  8. #8
    Codes B95 - B97 are "for use as supplementary or additional codes to identify the infectious agent(s) in diseases classified elsewhere" per the "Notes" section of the ICD-10 manual.

  9. #9
    Columbia, MO
    I looked all over for that note and then decided I was mistaken and it was not there! Thanks for pointing it out I guess now you would need to use the N39.0 as first listed?

    Debra A. Mitchell, MSPH, CPC-H

  10. #10
    Question Correct Code Sequencing
    What if you put the A41.59 code first, then the N39.0 code next, and the B96.4 as the last code? Would this be more correct than simply putting A41.59 followed by N39.0? It seems to me that the sepsis is the systemic infection, the UTI is the localized infection, and the Proteus Mirabilis code is further describing the cause of the UTI. Any thoughts anyone?

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