A49.1 ICD-10-CM Code: Streptococcal infection, unspecified site
A49.1 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · free HCC coding tools
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FY 2026 Apr update / Certain infectious and parasitic diseases (A00-B99) / Other bacterial diseases (A30-A49)
A49.1
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceStreptococcal infection, unspecified site
A bacterial infection caused by streptococcus bacteria that has been identified but the specific location in the body where the infection occurs is not documented or specified. This is used when a streptococcal infection is confirmed but the site is unknown or not clearly documented.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
HistoricalHistorical
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
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for A49.1 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for A49.1 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for A49.1 in this effective period.
Excludes 1
Official- bacterial agents as the cause of diseases classified elsewhere (B95-B96)
- chlamydial infection NOS (A74.9)
- meningococcal infection NOS (A39.9)
- rickettsial infection NOS (A79.9)
- spirochetal infection NOS (A69.9)
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for A49.1 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for A49.1 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for A49.1 in this effective period.
Buddy Documentation Tip
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 A49.1 an HCC code?
No. A49.1 is a billable ICD-10-CM code with no mapping under the CMS-HCC V28 or V24 community payment models, and none under the ESRD, Part D RxHCC, or HHS-HCC models.
- Code
- A49.1
- Description
- Streptococcal infection, unspecified site
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF reference coefficient
- —
- Billable
- Yes
- Payment year
- 2026
Coder workflow notes
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This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
A49.1 is the ICD-10-CM diagnosis code for streptococcal infection, unspecified site. A bacterial infection caused by streptococcus bacteria that has been identified but the specific location in the body where the infection occurs is not documented or specified. This is used when a streptococcal infection is confirmed but the site is unknown or not clearly documented. A49.1 sits in the ICD-10-CM chapter for certain infectious and parasitic diseases (a00-b99), within the section covering other bacterial diseases (a30-a49).
A49.1 is a billable ICD-10-CM code, but the current payload does not show a mapping under the CMS-HCC V28 or V24 community payment models, 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.
Use this code only when the streptococcal infection site is truly unspecified; always query the provider if documentation indicates a specific anatomical location, as more specific codes (like A40 for sepsis or A41 for other sepsis) may be more appropriate.
HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for A49.1 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Use this code only when the streptococcal infection site is truly unspecified; always query the provider if documentation indicates a specific anatomical location, as more specific codes (like A40 for sepsis or A41 for other sepsis) may be more appropriate
- •This code should not be used if the infection site can be determined from clinical documentation; review the medical record thoroughly for any indication of infection location (respiratory, urinary, skin, etc.) before assigning this unspecified code