A54.86

Billable

Gonococcal sepsis

HCC Category Mapping

V28HCC 2 — Septicemia, Sepsis, Systemic Inflammatory Response Syndrome/Shock

0.455

V24HCC 2 — Septicemia, Sepsis, Systemic Inflammatory Response Syndrome/Shock

0.455

ESRDHCC 2 — Septicemia, Sepsis, Systemic Inflammatory Response Syndrome/Shock

0.000

What This Code Means

A serious bloodstream infection caused by the bacterium Neisseria gonorrhoeae, which spreads throughout the body and can affect multiple organs. This is a severe complication of untreated gonorrhea that requires immediate medical treatment.

Coding Tips

•Verify that sepsis is documented in the medical record with evidence of systemic infection from gonorrhea; do not code sepsis without explicit physician documentation
•Ensure this code is used only when gonorrhea has progressed to sepsis; for localized gonococcal infections without sepsis, use the appropriate site-specific A54 code instead

Clinical Significance

Gonococcal sepsis represents the most severe form of disseminated gonococcal infection, with Neisseria gonorrhoeae present in the bloodstream causing systemic inflammatory response. This is a life-threatening condition with high mortality that requires ICU-level care and reflects the highest acute illness burden in risk adjustment.

Documentation Requirements

✓Positive blood cultures for Neisseria gonorrhoeae
✓SIRS criteria met (temperature, heart rate, respiratory rate, WBC count)
✓Evidence of organ dysfunction (acute kidney injury, liver failure, coagulopathy, altered mental status)
✓Hemodynamic status: hypotension, vasopressor requirements
✓Source of primary gonococcal infection documented

Commonly Confused Codes

A41.9 (Sepsis, unspecified organism) — When the organism is confirmed as gonococcal, use A54.86 rather than the unspecified sepsis code R65.20 (Severe sepsis without septic shock) — This is a complication code used with sepsis codes; consider whether additional R65.2x coding is appropriate A54.89 (Other gonococcal infections) — For localized gonococcal infections without systemic sepsis criteria

Code Hierarchy

└A54Gonococcal infection └A54.8Other gonococcal infections └A54.86Gonococcal sepsis

└A54.86Gonococcal sepsis