A32.7
BillableListerial sepsis
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is A32.7 an HCC code?
Yes. A32.7 maps to Septicemia, Sepsis, Systemic Inflammatory Response Syndrome/Shock under the CMS-HCC V28 risk adjustment model (and Septicemia, Sepsis, Systemic Inflammatory Response Syndrome/Shock under V24).
HCC Category Mapping
RAF weights shown are the community, non-dual, aged base weights from the CMS risk adjustment model file. Actual per-patient RAF contribution depends on member segment, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains in use during the transition and for historical data.
MEAT Criteria for A32.7
For A32.7 to count as a valid HCC diagnosis in a given encounter, the provider's documentation must show MEAT: Monitor, Evaluate, Assess, or Treat. A diagnosis from a prior year does not carry forward automatically — it has to be re-documented and supported each calendar year.
- MMonitor: signs, symptoms, disease progression, or lab trending documented in the note
- EEvaluate: test results, medication response, or physical findings reviewed by the provider
- AAssess: explicit mention in the assessment or plan with acknowledgment of status
- TTreat: medication, referral, procedure, therapy, or counseling tied to the diagnosis
Only one of M/E/A/T is required to support the code, but the documentation must be specific enough to show that the provider actually addressed A32.7 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
A32.7 is the ICD-10-CM diagnosis code for listerial sepsis. A serious bloodstream infection caused by the bacterium Listeria monocytogenes that has spread throughout the body, causing a life-threatening systemic inflammatory response. This condition requires immediate medical treatment with antibiotics. A32.7 sits in the ICD-10-CM chapter for certain infectious and parasitic diseases (a00-b99), within the section covering other bacterial diseases (a30-a49).
Under the CMS-HCC V28 risk adjustment model, A32.7 maps to Septicemia, Sepsis, Systemic Inflammatory Response Syndrome/Shock (HCC 2) with a community, non-dual, aged base RAF weight of 0.455. The V24 model used during the PY2024–PY2025 transition mapped A32.7 the same way and at the same RAF weight. V28 is the CMS-HCC risk adjustment model that reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition.
Listerial sepsis is a serious infection that typically requires ICU-level care; ensure sepsis is documented and coded as the principal diagnosis when present. Because A32.7 maps to a payment HCC, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's Medicare Advantage risk adjustment score. When documentation is ambiguous, coders should issue a provider query rather than assume the highest-specificity variant.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for A32.7 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Listerial sepsis is a serious infection that typically requires ICU-level care; ensure sepsis is documented and coded as the principal diagnosis when present
- •Verify the source of infection (e.g., contaminated food, maternal-fetal transmission) and code any associated conditions like meningitis (A32.11) or bacteremia separately if documented
Clinical Significance
Listerial sepsis is a serious bloodstream infection caused by Listeria monocytogenes, primarily affecting pregnant women, neonates, elderly individuals, and immunocompromised patients. In pregnancy, it can cause miscarriage, stillbirth, or neonatal sepsis, making it a critical diagnosis requiring immediate ampicillin-based therapy.
Documentation Requirements
- ✓Blood cultures positive for Listeria monocytogenes
- ✓Documentation of sepsis criteria and systemic inflammatory response
- ✓Pregnancy status, gestational age, and fetal outcomes if applicable
- ✓Immune status and risk factors (age extremes, immunosuppression, pregnancy)
- ✓Suspected source of exposure (contaminated food products — soft cheeses, deli meats, unpasteurized dairy)
Commonly Confused Codes
- •A32.1 (Listerial meningitis) — Listeria commonly causes meningitis; A32.7 is specifically for sepsis without meningitis or code both if both are present
- •A41.9 (Sepsis, unspecified) — Use A32.7 when Listeria is identified, not the generic sepsis code
- •A32.9 (Listeriosis, unspecified) — Use A32.7 when sepsis is specifically documented, not the unspecified form