Enterococcus faecalis
Learn about Enterococcus faecalis (E. faecalis) diagnosis, including clinical documentation, medical coding, and treatment options. Find information on enterococcal infection identification, healthcare protocols, and best practices for managing E faecalis. This resource offers guidance for clinicians and healthcare professionals dealing with Enterococcus faecalis infections.
A common bacterial infection often found in the gut. Can cause infections in other body sites.
Varies depending on infection site. Can include fever, chills, pain, redness, swelling, or fatigue.
Hospitals, healthcare facilities, nursing homes. Can also occur in community settings.
ICD-10 Code Families
Complete code families applicable to B95.3
When to use each related code
| Description | When to use |
|---|---|
| Infection caused by Enterococcus faecalis bacteria. | Code when E. faecalis is confirmed as the causative agent of infection. Consider site specificity. |
| Infection caused by any Enterococcus species. | Use when Enterococcus is identified but species is unknown or unspecified. Includes E. faecium. |
| Infection caused by Vancomycin-Resistant Enterococcus. | Code when Enterococcus infection exhibits resistance to vancomycin. Specify species if known (e.g., VRE faecalis). |
Best-practice checklist
- ✓Document site of E. faecalis infection (e.g., UTI, wound)
- ✓Specify source of infection if known (e.g., catheter)
- ✓Note symptoms and signs (e.g., fever, pain)
- ✓Document antibiotic susceptibility results
- ✓Include any relevant comorbidities or risk factors
Common pitfalls to avoid
Confusing localized enterococcal infection with sepsis can lead to inaccurate coding and inflated reimbursement.
Lack of documentation specifying the infection site (e.g., UTI, wound) may cause coding errors and rejected claims.
Proper POA indicator for enterococcal infections is crucial for accurate reporting and affects hospital-acquired infection metrics.
Best-practice tips
- 01Proper hand hygiene reduces E. faecalis transmission. ICD-10: B95.2
- 02Prompt catheter removal prevents enterococcal infections. CDI query: Catheter duration?
- 03Targeted antibiotic therapy based on culture sensitivity. CPT: 87070, 87186
- 04Infection control protocols for isolation precautions. SNOMED CT: 409463002
- 05Appropriate CDI, including infection source, for accurate coding. HCC: 188
Step-by-step checklist
- 1
Verify positive culture for E. faecalis (ICD-10 B95.2)
- 2
Review patient history for risk factors (e.g., UTI, endocarditis)
- 3
Assess for typical symptoms (e.g., fever, chills, pain)
- 4
Consider vancomycin resistance; check susceptibility testing
Ready-to-paste narrative
Patient presents with signs and symptoms suggestive of Enterococcus faecalis infection. Clinical presentation includes [specific symptoms e.g., fever, chills, urinary urgency, dysuria, abdominal pain, wound infection, bacteremia]. Differential diagnosis considered [list relevant differentials, e.g., UTI caused by other organisms, intra-abdominal abscess, catheter-related bloodstream infection]. Diagnostic workup includes [mention tests performed e.g., urine culture, blood culture, wound culture, imaging studies]. Laboratory results confirm the presence of E. faecalis. Sensitivity testing reveals susceptibility to [list antibiotics, e.g., ampicillin, vancomycin, gentamicin]. The patient's medical history includes [relevant past medical history, e.g., diabetes, recent surgery, indwelling catheter, immunosuppression]. Assessment indicates [state the diagnosis e.g., urinary tract infection, bacteremia, endocarditis, wound infection] due to Enterococcus faecalis. Treatment plan includes [specify antibiotics and dosage e.g., IV ampicillin 1g q6h, oral amoxicillin-clavulanate 875mg BID] and supportive care. Patient education provided regarding medication adherence, potential side effects, and follow-up care. Plan to monitor patient response to therapy and adjust treatment as needed. ICD-10 code [relevant ICD-10 code, e.g., B95.2 for Enterococcal infection as the cause of diseases classified elsewhere, N71.9 for Urinary tract infection, site not specified] considered for medical billing and coding purposes. Prognosis is [state prognosis based on patient specific factors e.g., good with appropriate antibiotic therapy]. Continued monitoring and reassessment are necessary.
Common questions and answers
What are the most effective treatment strategies for vancomycin-resistant Enterococcus faecalis (VRE) bacteremia in critically ill patients?+
Vancomycin-resistant Enterococcus faecalis (VRE) bacteremia in critically ill patients presents a serious therapeutic challenge. Treatment strategies typically involve a combination of antibiotics based on susceptibility testing, often including agents like linezolid, daptomycin, or tigecycline. Source control, such as removal of infected catheters or drainage of abscesses, is crucial. Consider implementing an antimicrobial stewardship program to optimize antibiotic use and minimize resistance development. Explore how combination therapy and newer agents like quinupristin-dalfopristin may play a role in managing complex VRE infections. Consultation with an infectious disease specialist is highly recommended. Learn more about individualized approaches to VRE treatment based on patient-specific factors and local resistance patterns.
How can I differentiate Enterococcus faecalis endocarditis from other causes of infective endocarditis in clinical practice?+
Differentiating Enterococcus faecalis endocarditis from other causes of infective endocarditis requires a multifaceted approach. While clinical presentation may involve fever, heart murmur, and embolic phenomena, these are not specific to E. faecalis. Blood cultures are essential for diagnosis, and identification of E. faecalis requires specific laboratory testing. Echocardiography plays a vital role in visualizing vegetations and assessing cardiac complications. Distinguishing E. faecalis from other pathogens like Staphylococcus aureus or Streptococcus species is critical for guiding appropriate antibiotic therapy. Explore how the Duke criteria can be used to assist in the diagnosis of infective endocarditis. Consider implementing specific diagnostic algorithms for infective endocarditis which incorporate microbiological and imaging findings. Learn more about the pathogenesis and clinical course of Enterococcus faecalis endocarditis to optimize patient outcomes.
What are the recommended prophylactic antibiotic regimens for surgical procedures to prevent Enterococcus faecalis surgical site infections (SSIs)?+
Preventing Enterococcus faecalis surgical site infections (SSIs) requires careful consideration of prophylactic antibiotic regimens. While guidelines may vary depending on the specific procedure and patient risk factors, evidence suggests that targeting E. faecalis with appropriate antibiotics can significantly reduce SSI rates. Cephalosporins, such as cefazolin, are commonly used for surgical prophylaxis. However, in cases with a high risk of enterococcal infection, or known colonization with VRE, consider implementing an antibiotic regimen that includes coverage for enterococci, such as ampicillin or vancomycin (for VRE). Explore how risk stratification tools can help identify patients who may benefit from targeted E. faecalis prophylaxis. Learn more about optimizing surgical preparation and intraoperative techniques to minimize the risk of SSIs. Consultation with an infectious disease specialist can be invaluable in complex cases.
Clinical accuracy: This information is provided for documentation and coding guidance and should not replace professional medical judgment.
Coding standard: ICD-10-CM, current FY guidelines.