B95.5
BillableUnspecified streptococcus as the cause of diseases classified elsewhere
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is B95.5 an HCC code?
No. B95.5 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
B95.5 is the ICD-10-CM diagnosis code for unspecified streptococcus as the cause of diseases classified elsewhere. Streptococcus bacteria of an unspecified type identified as the cause of another disease or infection. B95.5 sits in the ICD-10-CM chapter for certain infectious and parasitic diseases (a00-b99), within the section covering bacterial and viral infectious agents (b95-b97).
B95.5 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.
Use only when the specific streptococcus species cannot be determined.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for B95.5 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Use only when the specific streptococcus species cannot be determined
- •Pair with the primary diagnosis code for the infection caused by the bacteria