A54.42

HCC Category Mapping

What This Code Means

This is a joint infection caused by the bacterium Neisseria gonorrhoeae, which is transmitted through sexual contact. The infection causes inflammation, pain, and swelling in the affected joint or joints.

Coding Tips

• •Verify documentation specifies gonococcal arthritis rather than other types of arthritis; the causative organism must be identified as gonorrhea
• •Determine if the condition is acute or chronic, and identify the specific joint(s) affected, as additional codes may be needed for laterality and site specificity

Clinical Significance

Gonococcal arthritis is the most common musculoskeletal manifestation of disseminated gonococcal infection, typically presenting as acute monoarticular or oligoarticular septic arthritis. It requires urgent joint aspiration and IV antibiotics to prevent permanent joint destruction and reflects significant acute illness complexity.

Documentation Requirements

• ✓Positive Neisseria gonorrhoeae culture from synovial fluid or blood, or positive NAAT
• ✓Specific joint(s) affected with laterality documented
• ✓Synovial fluid analysis results (WBC count, Gram stain, culture)
• ✓Clinical presentation: acute onset, joint swelling, erythema, limited range of motion
• ✓Documentation of whether the infection is acute or chronic, and treatment response

Commonly Confused Codes