Facebook tracking pixel
B96.5
ICD-10-CM
Pseudomonas Infection

Learn about Pseudomonas infection diagnosis, including clinical documentation, medical coding (ICD-10 codes), and healthcare best practices. Find information on Pseudomonas aeruginosa, antibiotic susceptibility testing, microbiology lab results, and treatment options. This resource covers relevant information for healthcare professionals, clinicians, and medical coders seeking accurate and up-to-date guidance on Pseudomonas infection diagnosis and management.

Also known as

Pseudomonas aeruginosa infection
Pseudomonas sepsis
Pseudomonas pneumonia

Diagnosis Snapshot

Key Facts
  • Definition : Infection caused by Pseudomonas bacteria, often resistant to many antibiotics.
  • Clinical Signs : Fever, chills, inflammation, pus, and depending on site, symptoms like cough, burning with urination, or ear pain.
  • Common Settings : Hospitals, healthcare facilities, wounds, lungs (especially in cystic fibrosis), urinary tract, and bloodstream.

Related ICD-10 Code Ranges

Complete code families applicable to AAPC B96.5 Coding
A40-A41

Other bacterial diseases

Covers infections by Pseudomonas, like Pseudomonas aeruginosa.

B95-B98

Other bacterial agents as the cause

Includes Pseudomonas as a cause of diseases classified elsewhere.

J00-J99

Diseases of the respiratory system

May include Pseudomonas infections like pneumonia or bronchitis.

Code-Specific Guidance

Decision Tree for

Follow this step-by-step guide to choose the correct ICD-10 code.

Is the Pseudomonas infection site specified?

  • Yes

    Is it a UTI?

  • No

    Code as A49.8, B96.5 if confirmed as principal

Code Comparison

Related Codes Comparison

When to use each related code

Description
Pseudomonas infection
Gram-negative bacteremia
Sepsis

Documentation Best Practices

Documentation Checklist
  • Pseudomonas infection diagnosis documentation
  • Confirm Pseudomonas aeruginosa with lab tests
  • Specify infection site (e.g., lung, UTI)
  • Document antibiotic susceptibility results
  • Note patient symptoms and severity

Coding and Audit Risks

Common Risks
  • Unspecified Site

    Coding Pseudomonas infection without specifying the infection site leads to inaccurate severity and reimbursement.

  • Clinical Validation

    Lack of proper clinical documentation to support Pseudomonas infection diagnosis can cause audit failures and denials.

  • Sepsis Miscoding

    Incorrectly coding sepsis due to Pseudomonas or vice-versa can impact quality reporting and reimbursement.

Mitigation Tips

Best Practices
  • Document infection site, onset, and symptoms for accurate ICD-10 coding (e.g., A49.8, J15.1)
  • Specify Pseudomonas type (e.g., aeruginosa) for precise coding and antibiotic guidance
  • Order appropriate cultures (blood, urine, sputum) before starting antibiotics
  • Review antibiotic susceptibility results for optimal treatment and CDI
  • Monitor and document treatment response for compliance and improved patient outcomes

Clinical Decision Support

Checklist
  • 1. Verify culture site (e.g., sputum, blood, urine)
  • 2. Confirm Gram-negative rod morphology
  • 3. Check oxidase test positivity
  • 4. Review patient risk factors (e.g., CF, burns, devices)

Reimbursement and Quality Metrics

Impact Summary
  • Pseudomonas Infection: Reimbursement and Quality Metrics Impact Summary
  • Keywords: Pseudomonas, Infection, Medical Billing, Coding, ICD-10, DRG, Hospital Reporting, Reimbursement, Quality Metrics, Sepsis, Pneumonia, UTI, Bacteremia
  • Impact 1: Accurate coding (A49.0-A49.9, B96.5, J15.1, etc.) impacts DRG assignment and reimbursement.
  • Impact 2: Sepsis or severe infection increases resource use, affecting hospital costs and potential penalties.
  • Impact 3: Pseudomonas antibiotic resistance affects treatment success, impacting quality scores and outcomes.
  • Impact 4: Timely and effective treatment reduces LOS, improving efficiency metrics and patient satisfaction.

Streamline Your Medical Coding

Let S10.AI help you select the most accurate ICD-10 codes. Our AI-powered assistant ensures compliance and reduces coding errors.

Quick Tips

Practical Coding Tips
  • Code Pseudomonas site precisely
  • Document antibiotic susceptibility
  • Check for sepsis/bacteremia codes
  • Confirm infection, not colonization
  • Query physician if diagnosis unclear

Documentation Templates

Patient presents with signs and symptoms suggestive of Pseudomonas aeruginosa infection.  Presenting complaints include purulent sputum production, fever, chills, and dyspnea consistent with potential pneumonia.  Alternatively, the patient may exhibit localized symptoms such as wound infection with green, foul-smelling drainage, otitis externa, or urinary tract infection depending on the site of infection.  Relevant medical history includes cystic fibrosis, recent hospitalization, prolonged antibiotic use, or immune compromise, increasing the risk of Pseudomonas infection.  Physical examination reveals rales or rhonchi in suspected pulmonary involvement, erythema, edema, and tenderness at the site of localized infection, or other relevant clinical findings.  Differential diagnosis includes other bacterial infections such as Klebsiella pneumoniae, Escherichia coli, and Staphylococcus aureus.  Preliminary diagnosis of Pseudomonas infection is based on clinical presentation and supported by laboratory findings.  Sputum culture, wound culture, urine culture, or blood culture, depending on the site of infection, will be performed to confirm the diagnosis and identify antibiotic susceptibility.  Treatment plan includes initiation of empiric antibiotic therapy with antipseudomonal agents such as ceftazidime, cefepime, piperacillin-tazobactam, or carbapenems, considering patient allergies and local resistance patterns.  Treatment will be adjusted based on culture and sensitivity results.  Patient education regarding medication adherence, infection control measures, and follow-up care will be provided.  The patient will be monitored for clinical improvement and potential complications such as sepsis or antibiotic-related adverse effects.  ICD-10 codes will be assigned based on the specific site and type of Pseudomonas infection, such as J15.1 for Pseudomonas pneumonia or B96.5 for Pseudomonas as the cause of diseases classified elsewhere.  Appropriate CPT codes for diagnostic tests and therapeutic procedures will be documented for billing and coding purposes.  Continued monitoring and reassessment will be performed to ensure optimal clinical outcomes and appropriate management of the Pseudomonas infection.
Pseudomonas Infection - AI-Powered ICD-10 Documentation