A05.2 ICD-10-CM Code: Foodborne Clostridium perfringens [Clostridium welchii] intoxication
HCC Buddy Code Card
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FY 2026 Apr update / Certain infectious and parasitic diseases (A00-B99) / Intestinal infectious diseases (A00-A09)
A05.2
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceFoodborne Clostridium perfringens [Clostridium welchii] intoxication
This is a type of food poisoning caused by bacteria called Clostridium perfringens that grow in improperly stored or cooked food. The bacteria produce toxins in the intestines that cause cramping and diarrhea, typically appearing 8-16 hours after eating contaminated food.
CMS-HCC V28
00
RAF 0
CMS-HCC V24
00
RAF 0
ACA/HHS
00
RAF 0
ESRD/PACE
00
RAF 0
RXHCC
00
RAF 0
Code Trumping
Basket needed
Code Book Path
Inclusion Terms
Official- Enteritis necroticans
- Pig-bel
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for A05.2 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for A05.2 in this effective period.
Excludes 1
Official- Clostridium difficile foodborne intoxication and infection (A04.7-)
- Escherichia coli infection (A04.0-A04.4)
- listeriosis (A32.-)
- salmonella foodborne intoxication and infection (A02.-)
- toxic effect of noxious foodstuffs (T61-T62)
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for A05.2 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for A05.2 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for A05.2 in this effective period.
Buddy Documentation Tip
Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.
Is A05.2 an HCC code?
No. A05.2 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
A05.2 is the ICD-10-CM diagnosis code for foodborne clostridium perfringens [clostridium welchii] intoxication. This is a type of food poisoning caused by bacteria called Clostridium perfringens that grow in improperly stored or cooked food. The bacteria produce toxins in the intestines that cause cramping and diarrhea, typically appearing 8-16 hours after eating contaminated food. A05.2 sits in the ICD-10-CM chapter for certain infectious and parasitic diseases (a00-b99), within the section covering intestinal infectious diseases (a00-a09).
A05.2 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.
This code is used when the patient has confirmed or suspected foodborne illness from C. perfringens; document the source of exposure (specific food item) when available to support medical necessity.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for A05.2 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This code is used when the patient has confirmed or suspected foodborne illness from C. perfringens; document the source of exposure (specific food item) when available to support medical necessity
- •Do not use this code for C. difficile infections (use A04.7x instead) or for non-foodborne clostridial infections; ensure the documentation clearly indicates the food-related transmission route