A04.71 ICD-10-CM Code: Enterocolitis due to Clostridium difficile, recurrent

A04.71 is the ICD-10-CM diagnosis code for enterocolitis due to clostridium difficile, recurrent. This is a bacterial infection of the colon caused by Clostridium difficile that has occurred more than once in the same patient. The infection causes inflammation and diarrhea, typically following antibiotic use that disrupts normal gut bacteria. A04.71 sits in the ICD-10-CM chapter for certain infectious and parasitic diseases (a00-b99), within the section covering intestinal infectious diseases (a00-a09).

A04.71 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 clearly indicates this is a recurrent episode (not the initial occurrence) - recurrent C. difficile requires the specific A04.71 code rather than A04.70 for non-recurrent cases.