A54.1 ICD-10-CM Code: Gonococcal infection of lower genitourinary tract with periurethral and accessory gland abscess

A54.1 is the ICD-10-CM diagnosis code for gonococcal infection of lower genitourinary tract with periurethral and accessory gland abscess. A bacterial infection caused by gonorrhea that has spread to create a pus-filled pocket (abscess) around the urethra and nearby glands in the lower genital area. This is a complication of untreated gonorrhea that requires medical attention. A54.1 sits in the ICD-10-CM chapter for certain infectious and parasitic diseases (a00-b99), within the section covering infections with a predominantly sexual mode of transmission (a50-a64).

A54.1 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.

This code is specific to gonococcal infection with abscess formation; do not use if abscess is not present or if infection is limited to the urethra alone.