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B95.7 ICD-10-CM Code: Other staphylococcus as the cause of diseases classified elsewhere

ICD-10-CM Code View

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FY 2026 Apr update / Certain infectious and parasitic diseases (A00-B99) / Bacterial and viral infectious agents (B95-B97)

B95.7

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Other staphylococcus as the cause of diseases classified elsewhere

This code indicates that a staphylococcus bacteria (other than the common types like MRSA or aureus) caused an infection or disease in the patient. It's used as a secondary code to identify the specific bacterial cause when the main diagnosis code doesn't specify which type of staph was responsible.

CMS-HCC V28

0

0

RAF 0

CMS-HCC V24

0

0

RAF 0

ACA/HHS

0

0

RAF 0

ESRD/PACE

0

0

RAF 0

RXHCC

0

0

RAF 0

Code Trumping

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Code Book Path

Official
B95Streptococcus, Staphylococcus, and Enterococcus as the cause of diseases classified elsewhere
B95.7Other staphylococcus as the cause of diseases classified elsewhere

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for B95.7 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for B95.7 in this effective period.

Related Child Codes

Official
B95.0Streptococcus, group A, as the cause of diseases classified elsewhere
B95.1Streptococcus, group B, as the cause of diseases classified elsewhere
B95.2Enterococcus as the cause of diseases classified elsewhere
B95.3Streptococcus pneumoniae as the cause of diseases classified elsewhere
B95.4Other streptococcus as the cause of diseases classified elsewhere

Includes

Official

ICD-10-CM does not list Includes notes for B95.7 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for B95.7 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for B95.7 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for B95.7 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for B95.7 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance
This is a secondary code that must be paired with a primary diagnosis code describing the actual infection or disease (such as pneumonia, wound infection, or sepsis)
Use this code only when the documentation specifies a staphylococcus species other than S. aureus or methicillin-resistant S. aureus (MRSA), which have their own specific codes

Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.

Is B95.7 an HCC code?

No. B95.7 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.

Coder workflow notes

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This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).

What This Code Means

B95.7 is the ICD-10-CM diagnosis code for other staphylococcus as the cause of diseases classified elsewhere. This code indicates that a staphylococcus bacteria (other than the common types like MRSA or aureus) caused an infection or disease in the patient. It's used as a secondary code to identify the specific bacterial cause when the main diagnosis code doesn't specify which type of staph was responsible. B95.7 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).

B95.7 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 secondary code that must be paired with a primary diagnosis code describing the actual infection or disease (such as pneumonia, wound infection, or sepsis).

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for B95.7 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • This is a secondary code that must be paired with a primary diagnosis code describing the actual infection or disease (such as pneumonia, wound infection, or sepsis)
  • Use this code only when the documentation specifies a staphylococcus species other than S. aureus or methicillin-resistant S. aureus (MRSA), which have their own specific codes

Child Codes

Code Hierarchy

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