Question 1

What is ICD-10 code A58?

Accepted Answer

A58 is the ICD-10-CM diagnosis code for granuloma inguinale. Granuloma inguinale is a sexually transmitted bacterial infection that causes progressive ulcers and sores in the genital and groin area. It is caused by the bacterium Klebsiella granulomatis and can lead to tissue destruction if left untreated. A58 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).

A58 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 is a reportable sexually transmitted infection in most jurisdictions; verify local reporting requirements when assigning this code.

Question 2

Is A58 an HCC code?

Accepted Answer

No. A58 is a billable ICD-10-CM code but does not map to any payment HCC category under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can still be reported on Medicare Advantage encounter data submissions, but it does not contribute to the beneficiary's Risk Adjustment Factor (RAF) score and therefore does not affect the risk-adjusted capitation payment to the plan. V28 reached 100% phase-in for payment year 2026.

Question 3

Is A58 billable?

Accepted Answer

Yes. A58 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. A58 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

Question 4

What is the V28 vs V24 difference for A58?

Accepted Answer

A58 does not map to a payment HCC under either the CMS-HCC V28 risk adjustment model or the older V24 model. V28 reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition. Because neither model rewards A58 with a risk adjustment factor, it contributes zero to a Medicare Advantage beneficiary's RAF score in either version. Coders should check whether provider documentation supports a more specific child code that does map to a payment HCC.

Question 5

What should coders know when reporting A58?

Accepted Answer

This is a reportable sexually transmitted infection in most jurisdictions; verify local reporting requirements when assigning this code Document the anatomical site of the lesion(s) if specified in the clinical documentation, as this may affect treatment planning and follow-up care

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A58

Is A58 an HCC code?

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A58 ICD-10-CM Code: Granuloma inguinale

HCC Buddy Code Card

A58

Is A58 an HCC code?

What This Code Means

Coding Tips

Code Hierarchy

Work A58 in HCC Buddy