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A48.51 ICD-10-CM Code: Infant botulism

A48.51 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · HCC Buddy coding tools

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Code lookupA48.51

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

A48.51

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

Infant botulism

Infant botulism is a serious condition where toxins produced by Clostridium botulinum bacteria grow in a baby's intestines, causing muscle weakness and paralysis. This condition typically affects infants under 12 months old and can result in difficulty feeding, weak crying, and in severe cases, respiratory failure.

OverviewRisk ModelsCode BookDocumentationAuditNotesEdition comparison

CMS-HCC V28

N/A

—

Not mapped

CMS-HCC V24

Historical

Historical

Not used for CY2026 payment

ACA/HHS

N/A

—

Not mapped

ESRD/PACE

N/A

—

Not mapped

RXHCC

N/A

—

Not mapped

Code Book Path

Official
A48Other bacterial diseases, not elsewhere classifiedA48.5Other specified botulismA48.51Infant botulism

Inclusion Terms

Official
  • Non-foodborne intoxication due to toxins of Clostridium botulinum [C. botulinum]Inherited from A48.5

Excludes 2

Official
  • carrier or suspected carrier of infectious disease (Z22.-)Inherited from A00-B99
  • infectious and parasitic diseases complicating pregnancy, childbirth and the puerperium (O98.-)Inherited from A00-B99
  • infectious and parasitic diseases specific to the perinatal period (P35-P39)Inherited from A00-B99
  • influenza and other acute respiratory infections (J00-J22)Inherited from A00-B99

Related Codes

Official
A48.52Wound botulism

Includes

Official
  • diseases generally recognized as communicable or transmissibleInherited from A00-B99

Excludes 1

Official
  • certain localized infections - see body system-related chaptersInherited from A00-B99, A48, A48.5
  • actinomycetoma (B47.1)Inherited from A00-B99, A48, A48.5
  • food poisoning due to toxins of Clostridium botulinum (A05.1)Inherited from A00-B99, A48, A48.5

Code First

Official

No Code First sequencing instructions are included in this display for A48.51. Check the code and parent instructions in the Code Book.

Use Additional

Official
  • code to identify resistance to antimicrobial drugs (Z16.-)Inherited from A00-B99

Code Also

Official

No Code Also instructions are included in this display for A48.51. Check the code and parent instructions in the Code Book.

Buddy Documentation Tip

HCC Buddy guidance
Verify the patient's age is documented as an infant (typically under 12 months) to ensure appropriate code selection, as botulism in older children and adults uses different codes
Look for documentation of the source (often honey exposure) and clinical manifestations such as constipation, hypotonia, weak cry, or respiratory compromise to support the diagnosis

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 A48.51 an HCC code?

No. A48.51 is a billable ICD-10-CM code with no mapping under the current CMS-HCC V28 community payment model, and none under the ESRD, Part D RxHCC, or HHS-HCC models.

Code
A48.51
Description
Infant botulism
HCC (V28)
No CMS-HCC V28 mapping
RAF reference coefficient
—
Billable
Yes
Payment year
2026

Coder workflow notes

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What This Code Means

A48.51 is the ICD-10-CM diagnosis code for infant botulism. Infant botulism is a serious condition where toxins produced by Clostridium botulinum bacteria grow in a baby's intestines, causing muscle weakness and paralysis. This condition typically affects infants under 12 months old and can result in difficulty feeding, weak crying, and in severe cases, respiratory failure. A48.51 sits in the ICD-10-CM chapter for certain infectious and parasitic diseases (a00-b99), within the section covering other bacterial diseases (a30-a49).

A48.51 is a billable ICD-10-CM code, but no current CMS-HCC V28 community payment mapping is shown, and none under the ESRD, Part D RxHCC, or HHS-HCC models. Do not assign risk adjustment value from this page when no source-backed mapping is shown; verify the applicable model and payment year.

Verify the patient's age is documented as an infant (typically under 12 months) to ensure appropriate code selection, as botulism in older children and adults uses different codes.

HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for A48.51 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • •Verify the patient's age is documented as an infant (typically under 12 months) to ensure appropriate code selection, as botulism in older children and adults uses different codes
  • •Look for documentation of the source (often honey exposure) and clinical manifestations such as constipation, hypotonia, weak cry, or respiratory compromise to support the diagnosis

Child Codes

A48.51Infant botulism
A48.52Wound botulism

Code Hierarchy

└A48Other bacterial diseases, not elsewhere classified└A48.5Other specified botulism└A48.51Infant botulism
└A48.51Infant botulism

Also searched as

  • A48 51
  • A4851

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