Medical Coding Haemophilus influenzae

ICD-10-CM Coding for Haemophilus influenzae

Here’s a clear and thorough guide for billing and ICD-10-CM coding for Haemophilus influenzae (H. influenzae) — not to be confused with the flu (influenza virus). This bacterium can cause serious invasive diseases like meningitis, epiglottitis, pneumonia, and sepsis.

Common ICD-10 Diagnosis Codes:

Vaccination Coding for Hib (Haemophilus influenzae type b)

Vaccination is specifically for Hib, primarily in pediatric populations.

CPT Codes – Hib Vaccine:

Vaccine Administration Codes:

Diagnosis Code for Immunization:

• Z23 – Encounter for immunization

Billing Tips

When treating H. influenzae infection:

• Use the most specific ICD-10 code (e.g., J14 for pneumonia).

• Document organism identification (via culture or PCR).

• If multiple complications are present, code each condition (e.g., meningitis and sepsis).

When billing for Hib vaccine:

• Use Z23 as the primary diagnosis.

• Ensure proper documentation of:

  • Manufacturer, lot number

  • Route, site of administration

  • Parent/guardian consent

  • Counseling (if billing 90460/90461)

Clinical and Coding Scenarios

Example 1: Hib Meningitis

• ICD-10: G00.0

• Supporting codes: Fever (R50.9), seizures (R56.9) if present

Example 2: Hib Pneumonia

• ICD-10: J14

• Avoid generic pneumonia codes unless cause is unknown

Example 3: Well-child visit with Hib vaccine

• CPT: 90648

• Admin: 90460 (if counseling given)

• ICD-10: Z23 + Z00.129 (routine child visit)

Compliance & Documentation Tips

• Use lab confirmation if billing for a specific organism (especially G00.0 or A41.3).

• Avoid generic infection codes when a specific bacterial etiology is documented.

• When giving the Hib vaccine:

  • Include documentation of education/counseling if using 90460

  • Include Z23 in diagnosis

• Check payer-specific policies: Some Medicaid/CHIP plans have unique guidelines for vaccine billing

Summary Coding Table

https://www.cdc.gov/hi-disease/php/surveillance/index.html#:~:text=National%20Notifiable%20Diseases%20Surveillance%20System,Diseases%20Surveillance%20System%20(NNDSS).