A38.8 ICD-10-CM Code: Scarlet fever with other complications
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)
A38.8
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceScarlet fever with other complications
Scarlet fever is a bacterial infection caused by streptococcus that produces a characteristic red rash, and this code is used when the patient has scarlet fever along with complications other than the typical ones. Complications might include issues affecting the heart, kidneys, or other organs.
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
OfficialICD-10-CM does not list inclusion terms for A38.8 in this effective period.
Excludes 2
Official- streptococcal sore throat (J02.0)
Related Child Codes
Includes
Official- scarlatina
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for A38.8 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for A38.8 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for A38.8 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for A38.8 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 A38.8 an HCC code?
No. A38.8 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
A38.8 is the ICD-10-CM diagnosis code for scarlet fever with other complications. Scarlet fever is a bacterial infection caused by streptococcus that produces a characteristic red rash, and this code is used when the patient has scarlet fever along with complications other than the typical ones. Complications might include issues affecting the heart, kidneys, or other organs. A38.8 sits in the ICD-10-CM chapter for certain infectious and parasitic diseases (a00-b99), within the section covering other bacterial diseases (a30-a49).
A38.8 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.
Always review the medical record to identify and document the specific complications present, as code A38.8 should only be used when complications exist beyond the standard presentation.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for A38.8 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Always review the medical record to identify and document the specific complications present, as code A38.8 should only be used when complications exist beyond the standard presentation
- •Ensure the scarlet fever diagnosis is confirmed (typically caused by Group A Streptococcus) and document which complications are present to support medical necessity and potentially allow for additional diagnosis codes