Learn about the history of MRSA diagnosis, including key milestones in its identification, evolving treatment protocols, and the impact on healthcare. Explore clinical documentation best practices for MRSA infections, covering appropriate medical coding (ICD-10-CM codes) and SNOMED CT terminology. Understand the development of MRSA resistance and its implications for public health and infection control. This resource provides valuable information for healthcare professionals, clinicians, and medical coders seeking a comprehensive overview of MRSA diagnosis history.
Also known as
Personal history of MRSA
Indicates a past diagnosis of methicillin-resistant Staphylococcus aureus infection.
Carrier of MRSA
Identifies individuals who harbor MRSA without active infection.
Other staphylococcal infections
May be used if history of MRSA is not otherwise specified.
Follow this step-by-step guide to choose the correct ICD-10 code.
Is the MRSA infection currently active?
Yes
Do NOT code Z86.14. Code the active MRSA infection (e.g., L08.11, J15.212).
No
Is there a personal history of MRSA colonization?
When to use each related code
| Description |
|---|
| Methicillin-resistant S. aureus infection |
| Staphylococcus aureus infection, NOS |
| Infection due to Staphylococcus, unspecified |
Coding lacks specificity (active, resolved, colonized). Impacts quality metrics and reimbursement.
Insufficient clinical evidence to support history of MRSA diagnosis. Leads to denials and compliance issues.
Incorrect code assignment (e.g., screening vs. infection). Affects infection control data and reimbursement.
Q: What are the key historical milestones in the evolution of MRSA resistance to beta-lactam antibiotics, and how does this knowledge inform current treatment strategies?
A: Methicillin-resistant Staphylococcus aureus (MRSA) emerged shortly after the introduction of methicillin in 1960. Initially, MRSA infections were primarily nosocomial, or hospital-acquired. A key milestone was the acquisition of the *mecA* gene, which encodes for penicillin-binding protein 2a (PBP2a), conferring resistance to virtually all beta-lactam antibiotics. This resistance spread throughout hospitals worldwide. A later milestone involved the emergence of community-acquired MRSA (CA-MRSA) strains in the 1990s, often associated with the Panton-Valentine leukocidin (PVL) toxin gene, leading to skin and soft tissue infections in otherwise healthy individuals. Understanding this evolutionary trajectory is crucial for selecting appropriate antibiotic therapy. Empiric therapy for suspected MRSA infections often involves agents like vancomycin, daptomycin, or linezolid, reserving newer agents like ceftaroline or ceftobiprole for specific situations. Explore how local resistance patterns and patient-specific factors further influence MRSA treatment decisions.
Q: How did the changing epidemiology of MRSA, from primarily hospital-acquired to community-acquired infections, impact infection control practices and public health guidelines?
A: The shift in MRSA epidemiology from predominantly hospital-acquired (HA-MRSA) to community-acquired (CA-MRSA) infections significantly altered infection control strategies. Traditionally, infection control focused on hospital settings, including contact precautions, hand hygiene, and environmental disinfection. The emergence of CA-MRSA expanded the focus to community settings, emphasizing public health education on personal hygiene, wound care, and avoiding sharing personal items. The distinct genetic backgrounds of HA-MRSA and CA-MRSA also influenced molecular diagnostic methods for surveillance and outbreak investigations. Furthermore, the rise of CA-MRSA underscored the importance of decolonization strategies for both hospital and community settings to reduce the spread of MRSA. Consider implementing comprehensive infection control programs that address both HA-MRSA and CA-MRSA to mitigate the overall burden of MRSA infections.
Patient presents with a history of methicillin-resistant Staphylococcus aureus (MRSA) infection. Previous MRSA colonization or infection documented as per patient report and review of available medical records. The date of the initial MRSA diagnosis is (Date if available, otherwise state "unknown"). The site of the previous infection was (e.g., skin and soft tissue, pneumonia, bloodstream infection, etc.). Specific details regarding prior treatment include (e.g., incision and drainage, antibiotic therapy with specific medications and duration, etc.). Current presenting symptoms, if any, related to potential MRSA recurrence or complications include (e.g., fever, localized pain, erythema, purulent drainage, etc.). Patient reports (state patient's current concern if applicable regarding their MRSA history, such as concern for recurrence, anxiety regarding antibiotic resistance, or impact on daily life). Physical exam findings relevant to the history of MRSA include (e.g., presence or absence of scars, skin changes, or other relevant physical findings). Differential diagnoses considered include (list relevant differential diagnoses based on presenting symptoms, if any). Plan includes (outline the plan of care regarding the history of MRSA, such as patient education on infection prevention, monitoring for recurrence, or further diagnostic workup if indicated). This documentation addresses past medical history of MRSA infection, MRSA screening, MRSA treatment, antibiotic resistance, infection control, and recurring MRSA infection. Relevant ICD-10 codes include (list appropriate ICD-10 codes based on current presentation and reason for visit, including Z86.14 for personal history of MRSA). This documentation supports medical necessity for (state reason for visit and medical necessity relating to the history of MRSA, such as surveillance or management of complications).