A41.4 vs A48.0
A41.4 and A48.0 can never be reported together. ICD-10-CM declares them mutually exclusive with an Excludes1 note, meaning the two conditions cannot occur in the same patient — so exactly one of them is correct for any given encounter.
The official note, declared on A41.4
gas gangrene (A48.0)
A41.4
Sepsis due to anaerobes
Billable
- Chapter 1
- Certain infectious and parasitic diseases
- Section
- A30-A49
Indexed under
- Sepsis › anaerobic (generalized) (unspecified organism)
- Sepsis › Gram-negative › anaerobic (generalized) (unspecified organism)
- Infection, infected, infective › Clostridioides › difficile › sepsis (opportunistic)
- Infection, infected, infective › Clostridium NEC › difficile › sepsis (opportunistic)
- Infection, infected, infective › Clostridium NEC › perfringens › sepsis (opportunistic)
A48.0
Gas gangrene
Billable
- Chapter 1
- Certain infectious and parasitic diseases
- Section
- A30-A49
Use when the record says
- Clostridial cellulitis
- Clostridial myonecrosis
Indexed under
- Aerogenes capsulatus infection
- Myonecrosis, clostridial
- Abscess › anerobic (connective tissue) (embolic) (fistulous) (infective) (metastatic) (multiple) (pernicious) (pyogenic) (septic)
- Cellulitis › anaerobic (diffuse) (phlegmonous) (septic) (suppurative)
- Cellulitis › clostridial (diffuse) (phlegmonous) (septic) (suppurative)
Excludes1 is not always absolute: where two conditions covered by the note are genuinely unrelated, CMS guidance permits reporting both. Document the reasoning rather than assuming it. More on Excludes1 vs Excludes2 · FY2027