The B96.81 Diagnosis Code, a critical component of the International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM), specifically designates Helicobacter pylori [H. pylori] as the causative agent of diseases classified elsewhere. This code is essential for accurate medical billing and coding within the United States healthcare system, especially since the implementation of ICD-10-CM for service dates on or after October 1, 2015.
Decoding ICD-10-CM Code B96.81
B96.81 is categorized as a billable/specific code, meaning it is precise enough to be used for reimbursement purposes. Its concise description is “Helicobacter pylori as the cause of diseases classd elswhr,” clearly indicating its purpose. The 2025 edition of ICD-10-CM, which includes B96.81, became effective on October 1, 2024, highlighting its continued relevance in current medical classifications. It’s important to note that while this is the American ICD-10-CM version, international versions of ICD-10 B96.81 may have variations.
Synonyms and Clinical Relevance of B96.81
To fully grasp the scope of B96.81, understanding its approximate synonyms is crucial. These include:
- Gastric ulcer due to h pylori
- Gastritis, helicobacter pylori
- Helicobacter pylori gastrointestinal tract infection
- Helicobacter pylori infection
- Helicobacter-associated gastritis
- Helicobacter-associated pyloric ulcer
- Helicobactor pylori gastritis with hemorrhage
- Hemorrhagic gastritis due to helicobacter pylori
- Pyloric ulcer associated with helicobactor pylori
These synonyms underscore that B96.81 is utilized when H. pylori is confirmed as the underlying cause of conditions like gastritis and various types of ulcers within the gastrointestinal tract. The code emphasizes the etiological role of H. pylori in these diseases, which is vital for targeted treatment and epidemiological tracking.
B96.81 in Diagnostic Related Groups and Code History
ICD-10-CM code B96.81 falls under specific Diagnostic Related Groups (MS-DRG v42.0), which are used to classify hospital cases and determine reimbursement levels. This grouping further emphasizes the clinical and financial significance of accurately coding H. pylori-related conditions.
The code history of B96.81 reveals its stability within the ICD-10-CM system. Introduced in 2016 (effective October 1, 2015), it has remained unchanged through the 2025 edition, indicating consistent diagnostic criteria for Helicobacter pylori as a causative agent in various diseases. This stability is important for long-term data analysis and healthcare management.
Context within ICD-10-CM: Adjacent Codes
Understanding B96.81 also involves recognizing its place within the broader ICD-10-CM code set. It is positioned amongst other B96 codes, which denote “Other specified bacterial agents as the cause of diseases classified elsewhere.” Codes adjacent to B96.81 include those for other bacterial agents like Escherichia coli (E. coli), Hemophilus influenzae, Proteus, Pseudomonas, Bacteroides fragilis, and Clostridium perfringens. This context highlights that B96.81 is part of a larger classification system designed to specify bacterial causes for a range of diseases, aiding in precise diagnosis and treatment strategies.
In conclusion, the B96.81 diagnosis code is a vital tool for healthcare professionals in accurately classifying and coding conditions caused by Helicobacter pylori. Its specific nature, clear synonyms, and consistent presence within the ICD-10-CM system underscore its importance for medical documentation, reimbursement, and epidemiological understanding of H. pylori-related diseases.
