A06.5

HCC Category Mapping

What This Code Means

A lung abscess (a pocket of pus in the lung) caused by a parasitic infection from amoebas, typically acquired through contaminated food or water. This is a serious infection that can develop when amoebas spread from the intestines to the lungs.

Coding Tips

• •Verify documentation confirms amebic etiology rather than other causes of lung abscess; amebic lung abscess is relatively rare and requires specific diagnostic confirmation
• •Check for documentation of the primary amebic infection site (usually intestinal) as there may be additional codes needed to capture the complete clinical picture

Clinical Significance

Amebic lung abscess is a serious parasitic complication where Entamoeba histolytica, typically from a liver abscess, extends into the pulmonary space. This represents advanced amebiasis requiring both antiparasitic therapy and potentially interventional drainage, with significant morbidity if untreated.

Documentation Requirements

• ✓Confirmed or suspected Entamoeba histolytica infection with pulmonary involvement
• ✓Imaging (CT chest or chest X-ray) demonstrating lung abscess, consolidation, or pleural effusion
• ✓Documentation of route of spread (direct extension from hepatic abscess through diaphragm vs. hematogenous)
• ✓Serologic testing for E. histolytica (IgG antibodies) or stool antigen testing
• ✓Travel history or epidemiologic risk factors for amebiasis

Commonly Confused Codes