The A0472 Diagnosis code is a critical component of the International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) system. Specifically, A04.72 is designated for Enterocolitis due to Clostridium difficile, not specified as recurrent. This code is essential for medical billing, record-keeping, and epidemiological tracking within the healthcare system, particularly in the United States. For professionals in automotive-related fields who interact with health-related data, understanding these codes can be surprisingly relevant, especially in contexts involving insurance claims, employee health records, or understanding regulatory compliance related to health and safety.
Decoding ICD-10-CM Code A04.72
Introduced as a new code in 2018, A04.72 is a billable and specific code, meaning it is precise enough for claim reimbursements and detailed medical documentation. The “short description” officially associated with A04.72 is “Enterocolitis d/t Clostridium difficile, not spcf as recur,” further clarifying its scope. This code definitively points to a diagnosis of enterocolitis caused by Clostridium difficile (often referred to as C. difficile or C. diff), but explicitly excludes cases that are specified as recurrent. It’s important to note that the ICD-10-CM system undergoes annual updates, and while the 2025 edition is effective from October 1, 2024, code A04.72 itself has remained unchanged since its inception in terms of its definition and application. This stability is crucial for consistent data analysis and healthcare management.
Annotations and Context within ICD-10-CM
Within the ICD-10-CM framework, A04.72 is part of a larger group of codes and is referenced by various annotations. These annotations, such as “Applicable To,” “Code Also,” “Code First,” “Excludes1,” “Excludes2,” “Includes,” “Note,” or “Use Additional,” provide vital context and instructions for proper code usage. For A04.72, these back-references help to clarify when and how to use this code in relation to other related conditions or circumstances. Understanding these annotation back-references ensures accurate coding and reduces ambiguity in medical diagnoses and billing processes.
Furthermore, ICD-10-CM codes are often categorized into Diagnostic Related Groups (MS-DRGs). A04.72 falls under specific DRG groupings, which are used to classify diagnoses for hospital reimbursement and utilization review. Knowing the DRG associated with A04.72 can be important for healthcare facilities and insurance providers alike when assessing costs and managing resources.
Code History and Related Codes
The history of code A04.72 is straightforward: it was introduced in 2018 and has seen no modifications in subsequent yearly updates through 2025. This lack of change indicates a stable and well-defined diagnostic category within the ICD-10-CM system.
To provide a broader perspective, A04.72 is situated within the range of codes adjacent to it in the ICD-10-CM manual. It falls under the broader category of A04 – Other bacterial intestinal infections. More specifically, it is within the A04.7 – Enterocolitis due to Clostridium difficile subcategory. The code immediately preceding A04.72 is A04.71 – Enterocolitis due to Clostridium difficile, recurrent. This close proximity highlights the distinction between recurrent and non-recurrent C. difficile enterocolitis, a crucial differentiation for accurate diagnosis coding. Other related codes in the A04 range include various Escherichia coli infections (A04.0-A04.4), Campylobacter enteritis (A04.5), and other specified and unspecified bacterial intestinal infections (A04.8, A04.9). This context helps to position A04.72 within the spectrum of bacterial intestinal diseases.
Conclusion
In summary, the A0472 diagnosis code is a specific and billable ICD-10-CM code used to classify non-recurrent enterocolitis caused by Clostridium difficile. Its clear definition, stable history, and contextual annotations within the ICD-10-CM system make it a vital tool for accurate medical coding, billing, and epidemiological tracking. While seemingly distant from the automotive industry, understanding such codes is part of a broader landscape of data interpretation and regulatory awareness that can touch various professional fields. For detailed information and precise application, always refer to the official ICD-10-CM guidelines and resources.
