A41.53 ICD-10-CM Code: Sepsis due to Serratia

Code

A41.53

Description

Sepsis due to Serratia

HCC (V28)

HCC 2 — Septicemia, Sepsis, Systemic Inflammatory Response Syndrome/Shock

RAF reference coefficient

0.500

Billable

Yes

Payment year

2026

HCC Category Mapping

These are source-labeled model coefficients, not member totals. A category may still be removed by hierarchy or model cleanup rules. 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 context, hierarchy and cleanup rules, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains available for historical review.

Work A41.53 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT review for A41.53

What This Code Means

HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for A41.53 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

• •Always verify that sepsis is documented in the medical record before coding A41.53; sepsis requires systemic inflammatory response to confirmed infection
• •Check for associated organ dysfunction codes (such as acute kidney injury, acute respiratory distress syndrome) that should be coded separately to capture the full severity of the condition

Clinical Significance

Sepsis due to Serratia is a healthcare-associated gram-negative bloodstream infection caused by Serratia marcescens. It is notorious for contaminating medical equipment, IV fluids, and respiratory therapy devices. Serratia is intrinsically resistant to many first-line antibiotics, including ampicillin and first-generation cephalosporins, requiring targeted therapy.

Documentation Requirements

• ✓Blood cultures positive for Serratia species (typically S. marcescens)
• ✓Healthcare-associated infection assessment and documentation
• ✓Source of infection (central line, respiratory equipment, urinary catheter, contaminated medication)
• ✓Antibiotic susceptibility results documenting resistance pattern
• ✓Infection control investigation if outbreak is suspected

Commonly Confused Codes

• •A41.50 (Gram-negative sepsis, unspecified): Use A41.53 when Serratia is specifically identified
• •A41.59 (Other gram-negative sepsis): A41.53 has its own specific code; do not use the 'other' category for Serratia
• •A41.51 (Sepsis due to E. coli): Both are Enterobacteriaceae but different organisms requiring different antibiotic approaches

Child Codes