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A39.2 ICD-10-CM Code: Acute meningococcemia

A39.2 maps to CMS-HCC V28 2 (RAF 0.500). Documentation must support MEAT. MEAT criteria · RAF calculator · free HCC coding tools

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FY 2026 Apr update / Certain infectious and parasitic diseases (A00-B99) / Other bacterial diseases (A30-A49)

A39.2

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Acute meningococcemia

A serious bloodstream infection caused by meningococcal bacteria that develops rapidly and can be life-threatening. This condition occurs when the bacteria multiply in the blood and can lead to sepsis, organ failure, or meningitis if not treated immediately.

Buddy the Bee presenting code insight

Buddy Insight

Acute meningococcemia is a rapidly progressive bloodstream infection with Neisseria meningitidis that can progress from initial symptoms to death within hours.

CMS-HCC V28

HCC 2

RAF 0.500

CMS-HCC V24

HCC 2

RAF 0.352

ACA/HHS

HCC 2

Varies by metal level

ESRD/PACE

HCC 2

RAF 0.087

RXHCC

N/A

—

Not mapped

Code Book Path

Official
A39Meningococcal infection
A39.2Acute meningococcemia

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for A39.2 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for A39.2 in this effective period.

Related Child Codes

Official
A39.0Meningococcal meningitis
A39.1Waterhouse-Friderichsen syndrome
A39.3Chronic meningococcemia
A39.4Meningococcemia, unspecified
A39.5Meningococcal heart disease

Includes

Official

ICD-10-CM does not list Includes notes for A39.2 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for A39.2 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for A39.2 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for A39.2 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for A39.2 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance
Blood cultures or PCR positive for Neisseria meningitidis, or clinical diagnosis with characteristic presentation
Documentation of acuity — acute presentation with rapid onset
Rash description (petechiae, purpura, purpura fulminans)
Hemodynamic status and organ dysfunction assessment

MEAT Support

HCC Buddy guidance
Blood cultures or PCR positive for Neisseria meningitidis, or clinical diagnosis with characteristic presentation
Documentation of acuity — acute presentation with rapid onset
Rash description (petechiae, purpura, purpura fulminans)
Hemodynamic status and organ dysfunction assessment

Audit Caution

HCC Buddy guidance
Acute meningococcemia and meningococcal meningitis frequently coexist — code both A39.0 and A39.2 when both are documented
Always add R65.20/R65.21 when severe sepsis or septic shock is present
If Waterhouse-Friderichsen syndrome develops, add A39.1 — this is a distinct complication with adrenal hemorrhage
Close contacts require chemoprophylaxis — this is a clinical management issue but does not affect the index patient's coding

Common Mistakes

HCC Buddy guidance
A39.0 (Meningococcal meningitis) — A39.0 is CNS infection; A39.2 is bloodstream infection without meningitis — code both if meningitis and meningococcemia coexist
A39.3 (Chronic meningococcemia) — A39.2 is acute (days); A39.3 is chronic (weeks to months) with intermittent symptoms
A39.4 (Meningococcemia, unspecified) — Use A39.2 when acuity is documented as acute, not the unspecified code

Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →

Is A39.2 an HCC code?

Yes. A39.2 (Acute meningococcemia) 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), with a community non-dual aged RAF of 0.500. It is billable for payment year 2026.

Coder answer: A39.2 is billable and maps to V28 HCC 2, Septicemia, Sepsis, Systemic Inflammatory Response Syndrome/Shock. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.

Code
A39.2
Description
Acute meningococcemia
HCC (V28)
HCC 2 — Septicemia, Sepsis, Systemic Inflammatory Response Syndrome/Shock
RAF
0.500
Billable
Yes
Payment year
2026

HCC Category Mapping

V28HCC 2, Septicemia, Sepsis, Systemic Inflammatory Response Syndrome/Shock
0.500
V24HCC 2, Septicemia, Sepsis, Systemic Inflammatory Response Syndrome/Shock
0.352
ESRDHCC 2, Septicemia, Sepsis, Systemic Inflammatory Response Syndrome/Shock
0.087

Each model's RAF is its CMS base weight for that model's standard population, so weights are not directly comparable across models: CMS-HCC V28 and V24 use Community, Non-Dual, Aged; ESRD uses the dialysis continuing-enrollee model; RxHCC is the Part D continuing-enrollee, non-low-income, aged weight (a larger scale than CMS-HCC). ACA/HHS has no single weight — it varies by metal level. 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.

Work A39.2 in the Code Book — tabular path, V28 RAF, and MEAT checklist →

MEAT Criteria for A39.2

For A39.2 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 A39.2 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

A39.2 is the ICD-10-CM diagnosis code for acute meningococcemia. A serious bloodstream infection caused by meningococcal bacteria that develops rapidly and can be life-threatening. This condition occurs when the bacteria multiply in the blood and can lead to sepsis, organ failure, or meningitis if not treated immediately. A39.2 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, A39.2 maps to Septicemia, Sepsis, Systemic Inflammatory Response Syndrome/Shock (HCC 2) with a community, non-dual, aged base RAF weight of 0.500. Under the older V24 model, A39.2 mapped to the same category but with a base RAF weight of 0.352, V28 recalibrated weights across the entire model. 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.

This code represents the acute phase of meningococcal infection; verify documentation specifies meningococcemia (blood infection) rather than meningitis (brain/spinal cord infection), which would use a different code. Because A39.2 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 A39.2 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • •This code represents the acute phase of meningococcal infection; verify documentation specifies meningococcemia (blood infection) rather than meningitis (brain/spinal cord infection), which would use a different code
  • •Look for associated complications such as sepsis (R65.2x), acute respiratory distress syndrome, or disseminated intravascular coagulation, as these should be coded separately to capture disease severity

Clinical Significance

Acute meningococcemia is a rapidly progressive bloodstream infection with Neisseria meningitidis that can progress from initial symptoms to death within hours. It is characterized by petechial/purpuric rash, high fever, and potential for fulminant septic shock. Immediate empiric antibiotic therapy and close contacts' chemoprophylaxis are critical.

Documentation Requirements

  • ✓Blood cultures or PCR positive for Neisseria meningitidis, or clinical diagnosis with characteristic presentation
  • ✓Documentation of acuity — acute presentation with rapid onset
  • ✓Rash description (petechiae, purpura, purpura fulminans)
  • ✓Hemodynamic status and organ dysfunction assessment
  • ✓Serogroup identification if available (A, B, C, W, X, Y) for epidemiologic purposes

Commonly Confused Codes

  • •A39.0 (Meningococcal meningitis): A39.0 is CNS infection; A39.2 is bloodstream infection without meningitis: code both if meningitis and meningococcemia coexist
  • •A39.3 (Chronic meningococcemia): A39.2 is acute (days); A39.3 is chronic (weeks to months) with intermittent symptoms
  • •A39.4 (Meningococcemia, unspecified): Use A39.2 when acuity is documented as acute, not the unspecified code

Child Codes

A39.0Meningococcal meningitis
A39.1Waterhouse-Friderichsen syndrome
A39.2Acute meningococcemia
HCC 2
A39.3Chronic meningococcemia
HCC 2
A39.4Meningococcemia, unspecified
HCC 2
A39.5Meningococcal heart disease
A39.8Other meningococcal infections
A39.9Meningococcal infection, unspecified

Code Hierarchy

└A39Meningococcal infection└A39.2Acute meningococcemia
└A39.2Acute meningococcemia

Because A39.2 maps to a payment HCC, the documentation must also satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's risk adjustment score.

A39.2 maps to CMS-HCC V28 category 2, Septicemia, Sepsis, Systemic Inflammatory Response Syndrome/Shock. See the ICD-10 to HCC mapping hub for how the V28 crosswalk works. Because A39.2 carries a payment HCC, you can see what it adds to a RAF score and check the documentation the chart needs before it is submitted.

Work A39.2 in HCC Buddy

Open A39.2 in the Code Book for the full Index-to-Tabular path, MEAT checklist, and V28 HCC mapping, or in the Encoder to code from a keyword search. Pro includes 7 days to try everything, no card required.

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