A37.81 ICD-10-CM Code: Whooping cough due to other Bordetella species with pneumonia
HCC Buddy Code Card
Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.
FY 2026 Apr update / Certain infectious and parasitic diseases (A00-B99) / Other bacterial diseases (A30-A49)
A37.81
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceWhooping cough due to other Bordetella species with pneumonia
This is a respiratory infection caused by a bacteria called Bordetella (other than the most common type) that causes severe coughing fits and has led to pneumonia as a complication. The pneumonia means the infection has spread to the lungs and is causing inflammation there.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
N/A—
Not mapped
ACA/HHS
N/A—
Not mapped
ESRD/PACE
N/A—
Not mapped
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for A37.81 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for A37.81 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for A37.81 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for A37.81 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for A37.81 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for A37.81 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for A37.81 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 A37.81 an HCC code?
No. A37.81 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
Coder workflow notes
Get the V28 RAF + MEAT cheat sheet
One printable page: confirm a code's V28 HCC status, its RAF weight, and the MEAT your note needs to make it stick. Free, no card.
Free PDF. No card. Unsubscribe anytime.
This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
A37.81 is the ICD-10-CM diagnosis code for whooping cough due to other bordetella species with pneumonia. This is a respiratory infection caused by a bacteria called Bordetella (other than the most common type) that causes severe coughing fits and has led to pneumonia as a complication. The pneumonia means the infection has spread to the lungs and is causing inflammation there. A37.81 sits in the ICD-10-CM chapter for certain infectious and parasitic diseases (a00-b99), within the section covering other bacterial diseases (a30-a49).
A37.81 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.
Verify documentation specifies both the whooping cough diagnosis AND pneumonia as a complication; both conditions must be documented to use this combination code.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for A37.81 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Verify documentation specifies both the whooping cough diagnosis AND pneumonia as a complication; both conditions must be documented to use this combination code
- •Confirm the causative organism is documented as a Bordetella species other than B. pertussis or B. parapertussis, as those have separate codes