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FY2027 ICD-10-CM reference

A40.9: Streptococcal sepsis, unspecified

By the HCC Buddy Coding Team

The official ICD-10-CM descriptor is Streptococcal sepsis, unspecified. The FY2027 annual edition starts October 1, 2026. Check the edition that applies to the encounter or inpatient discharge, including any April update.

Billable code. Verified against the official FY2027 order file.

CMS-HCC V28

  • HCC 2: Septicemia, Sepsis, Systemic Inflammatory Response Syndrome/Shock · RAF 0.500, Community Non-Dual Aged (CNA)

Payment year 2027, 2026 dates of service. HCC from the CMS 2027 Initial ICD-10-CM Mappings; RAF from the CMS-HCC V28 relative factors. For 2027 dates of service, CMS has not yet published the payment year 2028 mappings.

CMS-HCC V24

Not used for payment year 2027 Medicare Advantage payment

ESRD

Source verification pending

PACE

Source verification pending

RxHCC

Source verification pending

HHS-HCC

Source verification pending

FY2027 Tabular instructions

Instructions below include applicable chapter, section and parent-code notes. Each note identifies where it appears in the official source.

Includes

diseases generally recognized as communicable or transmissible

Source: A00-B99 (chapter, inherited).

Instructional note

code to identify resistance to antimicrobial drugs (Z16.-)

Source: A00-B99 (chapter, inherited).

Excludes2

carrier or suspected carrier of infectious disease (Z22.-)

Source: A00-B99 (chapter, inherited).

Excludes2

certain localized infections - see body system-related chapters

Source: A00-B99 (chapter, inherited).

Excludes2

infectious and parasitic diseases complicating pregnancy, childbirth and the puerperium (O98.-)

Source: A00-B99 (chapter, inherited).

Excludes2

infectious and parasitic diseases specific to the perinatal period (P35-P39)

Source: A00-B99 (chapter, inherited).

Excludes2

influenza and other acute respiratory infections (J00-J22)

Source: A00-B99 (chapter, inherited).

Code first

, if applicable, postprocedural sepsis (T81.44-)

Source: A40 (category, inherited).

Code first

sepsis due to central venous catheter (T80.211-)

Source: A40 (category, inherited).

Code first

streptococcal sepsis during labor (O75.3)

Source: A40 (category, inherited).

Code first

streptococcal sepsis following abortion or ectopic or molar pregnancy (O03.37, O03.87, O04.87, O07.37, O08.82)

Source: A40 (category, inherited).

Code first

streptococcal sepsis following immunization (T88.0-)

Source: A40 (category, inherited).

Code first

streptococcal sepsis following infusion, transfusion or therapeutic injection (T80.22-, T80.29-)

Source: A40 (category, inherited).

Excludes1

neonatal (P36.0-P36.1)

Source: A40 (category, inherited).

Excludes1

puerperal sepsis (O85)

Source: A40 (category, inherited).

Excludes1

sepsis due to Streptococcus, group D (A41.81)

Source: A40 (category, inherited).

Source: CMS FY2027 Tabular List and Alphabetic Index.

Open Tabular instructions and code details

Compare the FY2027 additions, removals and billable-status changes

What does A40.9 mean in FY2027?

The official ICD-10-CM descriptor is Streptococcal sepsis, unspecified. The FY2027 annual edition starts October 1, 2026. Check the edition that applies to the encounter or inpatient discharge, including any April update.

Is A40.9 billable in FY2027?

The FY2027 order file marks A40.9 as billable. Check the complete Tabular instructions and documentation before assigning it.

Does A40.9 map to an HCC?

In the CMS 2027 Initial ICD-10-CM Mappings (payment year 2027, 2026 dates of service), A40.9 maps to CMS-HCC V28 HCC 2 (Septicemia, Sepsis, Systemic Inflammatory Response Syndrome/Shock). For 2027 dates of service, CMS has not yet published the payment year 2028 mappings. ESRD, RxHCC, PACE and HHS-HCC mappings are still pending verification for FY2027.

Source: CMS FY2027 ICD-10-CM order file. Read the FY2027 Official Guidelines.

Review the FY2026 April edition