A49.01 ICD-10-CM Code: Methicillin susceptible Staphylococcus aureus infection, unspecified site

A49.01 is the ICD-10-CM diagnosis code for methicillin susceptible staphylococcus aureus infection, unspecified site. This code describes a bacterial infection caused by Staphylococcus aureus (a common bacteria) that responds to methicillin antibiotics, but the specific location of the infection in the body is not documented. It's used when a staph infection is confirmed but the exact site hasn't been specified in the medical record. A49.01 sits in the ICD-10-CM chapter for certain infectious and parasitic diseases (a00-b99), within the section covering other bacterial diseases (a30-a49).

A49.01 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.

Query the provider if a more specific infection site can be identified (such as skin, bone, bloodstream, or respiratory), as this would allow for a more precise code that may affect treatment and reimbursement.