A56.09
BillableOther chlamydial infection of lower genitourinary tract
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is A56.09 an HCC code?
No. A56.09 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
A56.09 is the ICD-10-CM diagnosis code for other chlamydial infection of lower genitourinary tract. This code describes a chlamydial infection (a sexually transmitted bacterial infection) affecting the lower urinary or reproductive tract that doesn't fit into more specific categories. It may involve the urethra, bladder, or other lower genital structures. A56.09 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).
A56.09 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.
Verify the specific site of infection in the lower genitourinary tract, as more specific codes (A56.01 for urethritis, A56.02 for cervicitis, A56.03 for proctitis) may be more appropriate if documented.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for A56.09 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Verify the specific site of infection in the lower genitourinary tract, as more specific codes (A56.01 for urethritis, A56.02 for cervicitis, A56.03 for proctitis) may be more appropriate if documented
- •Ensure the diagnosis specifies chlamydial infection and is not confused with other sexually transmitted infections; always check for documentation of treatment and consider reporting to public health authorities as required by law