B96.20 ICD-10-CM Code: Unspecified Escherichia coli [E. coli] as the cause of diseases classified elsewhere

B96.20 is the ICD-10-CM diagnosis code for unspecified escherichia coli [e. coli] as the cause of diseases classified elsewhere. This code indicates that E. coli bacteria caused a disease or infection in the patient, but the specific type of E. coli strain and the exact location or nature of the infection are not specified in the medical record. It is used as a secondary code to identify the causative organism when E. coli is responsible for another documented condition. B96.20 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).

B96.20 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 should only be used when another primary diagnosis code documents the actual disease or infection caused by E. coli (such as urinary tract infection, pneumonia, or sepsis).