Coding MRSA

Question 1

Coding MRSA 1a: Combination codes for MRSA infection

Answer 1

When a patient is diagnosed with an infection that is due to methicillin resistant Staphylococcus aureus (MRSA), and that infection has a combination code that includes the causal organism (eg, septicemia, pneumonia) assign the appropriate code for the condition (eg, code 038.12 MRSA septicemia or code 482.42 MRSA due to staphylococcus aureus.

DO NOT assign code 041.12 (MRSA) as an additonal code because the code includes the type of infection and the MRSA organism.

DO NOT assign a code from subcategory V09.0 (infection with microorganisms resistant to penicillins) as an additional diagnosis.

Question 2

Coding MRSA 1b: Other codes for MRSA infection

Answer 2

When there is documentation of a current infection (eg, wound infection, stitch abscess, urinary tract infection) due to MRSA, and that infection DOES NOT have a combination code that includes the causal organism, select the appropriate code to identify the condition along with code 041.12, (Methicillin resistant Staphylococcus aureus) for the MRSA infection.

DO NOT assigna a code from subvategory V09.0 (infection with microorganisms resistant to penicillins)

Question 3

Coding MRSA 1c: Methicillin susceptible Staphylococcus aureus (MSSA) and MRSA colonization

Answer 3

The conditions or stae of being colonized or carrying MSSA or MRSA is called colonization or carriage, while an individual person is described as being colonized or being a carrier. Colonization means that MSSA or MSRA is present on or in the body without necessarily causing illness. A positive MRSA colonization test might be documented by the provider as “MRSA screen positive” or “MRSA nasal swab positive.”

Assign code V02.54 (Carrier or suspected carrier, Methicillin resistant Staphylococcus aureus) for patients documentted as having MRSA colonization. Asdsign code V02.53 (Carier or suspected carrier, Methicillin susceptible staphylococcus aureus) for patients documented as having MSSA colonization. Colonization is not necessarily indicative of a disease process or as the cause of a specific condition the patient may have unless documented as such by the provider.

Code V02.59 (Other specified baceterial diseases)SHOULD be assigned for other types of staphylococcal colonization (eg, epidermidis, S. Saprophyticus).

Code V02.59 should NOT be assigned for colonization with any type of staphylococcus aureus (MRSA, MSSA).

Question 4

Coding MRSA 1d: MRSA colonization and infection

Answer 4

If a patient is documented as having both MRSA colonization and infection during a hospital admission, code V02.54 (Carrier or suspected carrier, Methicillin resistant Staphylococcus aureus) and a code for the MRSA infection may BOTH be assigned.