A04.6 ICD-10-CM Code: Enteritis due to Yersinia enterocolitica
A04.6 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · HCC coding software
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FY 2026 Apr update / Certain infectious and parasitic diseases (A00-B99) / Intestinal infectious diseases (A00-A09)
A04.6
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceEnteritis due to Yersinia enterocolitica
This is an infection of the small intestine caused by Yersinia enterocolitica bacteria, which typically causes diarrhea, abdominal pain, and fever. It is usually acquired through contaminated food or water.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
HistoricalHistorical
Not used for CY2026 payment
ACA/HHS
N/A—
Not mapped
ESRD/PACE
N/A—
Not mapped
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for A04.6 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for A04.6 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for A04.6 in this effective period.
Excludes 1
Official- extraintestinal yersiniosis (A28.2)
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for A04.6 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for A04.6 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for A04.6 in this effective period.
Buddy Documentation Tip
Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →
Is A04.6 an HCC code?
No. A04.6 is a billable ICD-10-CM code with no mapping under the CMS-HCC V28 or V24 community payment models, and none under the ESRD, Part D RxHCC, or HHS-HCC models.
- Code
- A04.6
- Description
- Enteritis due to Yersinia enterocolitica
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF reference coefficient
- —
- Billable
- Yes
- Payment year
- 2026
Coder workflow notes
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This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
A04.6 is the ICD-10-CM diagnosis code for enteritis due to yersinia enterocolitica. This is an infection of the small intestine caused by Yersinia enterocolitica bacteria, which typically causes diarrhea, abdominal pain, and fever. It is usually acquired through contaminated food or water. A04.6 sits in the ICD-10-CM chapter for certain infectious and parasitic diseases (a00-b99), within the section covering intestinal infectious diseases (a00-a09).
A04.6 is a billable ICD-10-CM code, but the current payload does not show a mapping under the CMS-HCC V28 or V24 community payment models, and none under the ESRD, Part D RxHCC, or HHS-HCC models. Do not assign risk adjustment value from this page when no source-backed mapping is shown; verify the applicable model and payment year.
Verify documentation confirms Yersinia enterocolitica as the causative organism; culture or stool test results should support this diagnosis.
HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for A04.6 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Verify documentation confirms Yersinia enterocolitica as the causative organism; culture or stool test results should support this diagnosis
- •Do not use this code for other types of bacterial enteritis; ensure the specific organism is documented before assigning this code
Excludes 1, Do NOT code together
- extraintestinal yersiniosis (A28.2)