B95.4 — Other streptococcus as the cause of diseases classified elsewhere
Is B95.4 billable?
Yes — B95.4 is billable for FY2027. B95.4 is a valid, billable ICD-10-CM code at the highest level of specificity in its branch. B95.4 may be submitted for encounters from October 1, 2026 through September 30, 2027.
B95.4 at a glance
| Code | B95.4 |
|---|---|
| Description | Other streptococcus as the cause of diseases classified elsewhere |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
What Medicare edits apply to B95.4?
The Medicare Code Editor screens inpatient claims before they are grouped. These edits name B95.4 directly.
CMS will reject this code as the principal diagnosis on an inpatient claim. It describes something other than the condition chiefly responsible for the admission.
Which MS-DRGs does B95.4 group to?
B95.4 sits in MDC 18 and helps define the logic of 3 MS-DRGs (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.
- 867Other Infectious and Parasitic Diseases Diagnoses with MCCmedical
- 868Other Infectious and Parasitic Diseases Diagnoses with CCmedical
- 869Other Infectious and Parasitic Diseases Diagnoses without CC/MCCmedical
How is B95.4 listed in the Alphabetic Index?
These are the routes through the Alphabetic Index that lead to B95.4. They show the wording a clinician may have documented, which often differs from the Tabular description.
- Streptococcus, streptococcal › specified NEC, as cause of disease classified elsewhere
- Infection, infected, infective › bacterial NOS › as cause of disease classified elsewhere › Streptococcus › specified NEC (opportunistic)
Use additional code — inherited from Chapter 1
Report an additional code alongside B95.4 to fully describe the condition. B95.4 is sequenced first.
- code to identify resistance to antimicrobial drugs (Z16.-)
Excludes2 — not included here — inherited from Chapter 1
The conditions below are not part of B95.4, but a patient may have both at the same time. When documentation supports it, B95.4 and the excluded code may both be reported.
- carrier or suspected carrier of infectious disease (Z22.-)
- certain localized infections - see body system-related chapters
- infectious and parasitic diseases complicating pregnancy, childbirth and the puerperium (O98.-)
- infectious and parasitic diseases specific to the perinatal period (P35-P39)
- influenza and other acute respiratory infections (J00-J22)
How long has B95.4 existed?
B95.4 has been in ICD-10-CM since at least FY2016, the earliest fiscal year on record here.
Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.
What other codes are in the B95 family? (8)
- B95.0Streptococcus, group A, as the cause of diseases classified elsewhere
- B95.1Streptococcus, group B, as the cause of diseases classified elsewhere
- B95.2Enterococcus as the cause of diseases classified elsewhere
- B95.3Streptococcus pneumoniae as the cause of diseases classified elsewhere
- B95.5Unspecified streptococcus as the cause of diseases classified elsewhere
- B95.6Staphylococcus aureus as the cause of diseases classified elsewherenot billable
- B95.7Other staphylococcus as the cause of diseases classified elsewhere
- B95.8Unspecified staphylococcus as the cause of diseases classified elsewhere