A05.1 ICD-10-CM Code: Botulism food poisoning
A05.1 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · HCC Buddy coding tools
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FY 2026 Apr update / Certain infectious and parasitic diseases (A00-B99) / Intestinal infectious diseases (A00-A09)
A05.1
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceBotulism food poisoning
Botulism food poisoning is a serious illness caused by eating food contaminated with botulinum toxin, a dangerous bacterial poison that affects the nerves and muscles. This condition can cause paralysis and requires immediate medical attention.
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
Official- Botulism NOS
- Classical foodborne intoxication due to Clostridium botulinum
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for A05.1 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for A05.1 in this effective period.
Excludes 1
Official- infant botulism (A48.51)
- wound botulism (A48.52)
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for A05.1 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for A05.1 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for A05.1 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 A05.1 an HCC code?
No. A05.1 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
- A05.1
- Description
- Botulism food poisoning
- 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
A05.1 is the ICD-10-CM diagnosis code for botulism food poisoning. Botulism food poisoning is a serious illness caused by eating food contaminated with botulinum toxin, a dangerous bacterial poison that affects the nerves and muscles. This condition can cause paralysis and requires immediate medical attention. A05.1 sits in the ICD-10-CM chapter for certain infectious and parasitic diseases (a00-b99), within the section covering intestinal infectious diseases (a00-a09).
A05.1 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 the source of contamination is food-related (not wound botulism or inhalation) before assigning A05.1, as other botulism codes exist for different transmission routes.
HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for A05.1 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Verify the source of contamination is food-related (not wound botulism or inhalation) before assigning A05.1, as other botulism codes exist for different transmission routes
- •Document the specific food source if available, as this information supports accurate coding and may be required for public health reporting