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A36.9

Billable

Diphtheria, unspecified

This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).

What This Code Means

Diphtheria is a serious bacterial infection caused by Corynebacterium diphtheriae that typically affects the throat and can produce a thick, grayish membrane that blocks the airway. This code is used when diphtheria is diagnosed but the specific type or affected site is not documented.

Coding Tips

  • If the documentation specifies the site of diphtheria (respiratory, cutaneous, etc.), use a more specific code (A36.0-A36.8) rather than the unspecified code A36.9
  • Diphtheria is a reportable disease in most jurisdictions; verify that appropriate public health reporting requirements are met when coding this diagnosis

Code Hierarchy

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