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A41

Non-Billable (Header)

Other sepsis

Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)

What This Code Means

A41 is the ICD-10-CM diagnosis code for other sepsis. A41 sits in the ICD-10-CM chapter for certain infectious and parasitic diseases (a00-b99), within the section covering other bacterial diseases (a30-a49).

Header codes like A41 cannot be reported on claims directly — they organize child codes that share clinical context but the actual diagnosis must be coded to the highest level of specificity supported by the documentation. Coders should look at A41's child codes and select the one that matches the patient's documented presentation, since payers reject header codes submitted as the primary diagnosis. For risk adjustment workflows, header codes never contribute to a Medicare Advantage member's RAF score on their own; only billable child codes that happen to map to a payment HCC affect risk-adjusted plan payments.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for A41 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Excludes 1 — Do NOT code together

  • bacteremia NOS (R78.81)
  • neonatal (P36.-)
  • puerperal sepsis (O85)
  • streptococcal sepsis (A40.-)

Excludes 2 — Not included here, may code separately

  • sepsis (due to) (in) actinomycotic (A42.7)
  • sepsis (due to) (in) anthrax (A22.7)
  • sepsis (due to) (in) candidal (B37.7)
  • sepsis (due to) (in) Erysipelothrix (A26.7)
  • sepsis (due to) (in) extraintestinal yersiniosis (A28.2)
  • sepsis (due to) (in) gonococcal (A54.86)
  • sepsis (due to) (in) herpesviral (B00.7)
  • sepsis (due to) (in) listerial (A32.7)
  • sepsis (due to) (in) melioidosis (A24.1)
  • sepsis (due to) (in) meningococcal (A39.2-A39.4)
  • sepsis (due to) (in) plague (A20.7)
  • sepsis (due to) (in) tularemia (A21.7)
  • toxic shock syndrome (A48.3)

Code First

  • , if applicable, postprocedural sepsis (T81.44-)
  • sepsis due to central venous catheter (T80.211-)
  • sepsis during labor (O75.3)
  • sepsis following abortion, ectopic or molar pregnancy (O03.37, O03.87, O04.87, O07.37, O08.82)
  • sepsis following immunization (T88.0-)
  • sepsis following infusion, transfusion or therapeutic injection (T80.22-, T80.29-)

Child Codes

Code Hierarchy

A41Other sepsis
A41Other sepsis

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