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B96.6 ICD-10-CM Code: Bacteroides fragilis [B. fragilis] 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)

B96.6

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

Bacteroides fragilis [B. fragilis] as the cause of diseases classified elsewhere

Bacteroides fragilis is a type of bacteria that causes infections elsewhere in the body. This code indicates the bacteria is the underlying cause of a disease classified in another ICD-10 category.

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
B96Other bacterial agents as the cause of diseases classified elsewhere
B96.6Bacteroides fragilis [B. fragilis] as the cause of diseases classified elsewhere

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for B96.6 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for B96.6 in this effective period.

Related Child Codes

Official
B96.0Mycoplasma pneumoniae [M. pneumoniae] as the cause of diseases classified elsewhere
B96.1Klebsiella pneumoniae [K. pneumoniae] as the cause of diseases classified elsewhere
B96.2Escherichia coli [E. coli ] as the cause of diseases classified elsewhere
B96.3Hemophilus influenzae [H. influenzae] as the cause of diseases classified elsewhere
B96.4Proteus (mirabilis) (morganii) as the cause of diseases classified elsewhere

Includes

Official

ICD-10-CM does not list Includes notes for B96.6 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for B96.6 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for B96.6 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for B96.6 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for B96.6 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance
This is a secondary code used to identify the causative organism; always code the primary condition first
Commonly associated with intra-abdominal infections, bacteremia, and anaerobic infections

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 B96.6 an HCC code?

No. B96.6 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

B96.6 is the ICD-10-CM diagnosis code for bacteroides fragilis [b. fragilis] as the cause of diseases classified elsewhere. Bacteroides fragilis is a type of bacteria that causes infections elsewhere in the body. This code indicates the bacteria is the underlying cause of a disease classified in another ICD-10 category. B96.6 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).

B96.6 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 used to identify the causative organism; always code the primary condition first.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for B96.6 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 used to identify the causative organism; always code the primary condition first
  • Commonly associated with intra-abdominal infections, bacteremia, and anaerobic infections

Child Codes

Code Hierarchy

Work B96.6 in HCC Buddy

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