A04.5
BillableCampylobacter enteritis
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is A04.5 an HCC code?
No. A04.5 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
A04.5 is the ICD-10-CM diagnosis code for campylobacter enteritis. Campylobacter enteritis is a bacterial infection of the intestines caused by Campylobacter bacteria, typically resulting in diarrhea, abdominal pain, and fever. This infection is commonly acquired from contaminated food or water, particularly undercooked poultry. A04.5 sits in the ICD-10-CM chapter for certain infectious and parasitic diseases (a00-b99), within the section covering intestinal infectious diseases (a00-a09).
A04.5 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.
Verify documentation specifies Campylobacter as the causative organism; do not assume based on symptoms alone.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for A04.5 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Verify documentation specifies Campylobacter as the causative organism; do not assume based on symptoms alone
- •Check for any complications (such as toxic megacolon or sepsis) that may require additional codes; also note if the patient has severe dehydration requiring IV therapy