B96.1 — Klebsiella pneumoniae [K. pneumoniae] as the cause of diseases classified elsewhere
Is B96.1 billable?
Yes — B96.1 is billable for FY2027. B96.1 is a valid, billable ICD-10-CM code at the highest level of specificity in its branch. B96.1 may be submitted for encounters from October 1, 2026 through September 30, 2027.
B96.1 at a glance
| Code | B96.1 |
|---|---|
| Description | Klebsiella pneumoniae [K. pneumoniae] 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 B96.1?
The Medicare Code Editor screens inpatient claims before they are grouped. These edits name B96.1 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 B96.1 group to?
B96.1 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 B96.1 listed in the Alphabetic Index?
These are the routes through the Alphabetic Index that lead to B96.1. They show the wording a clinician may have documented, which often differs from the Tabular description.
- Klebsiellapneumoniae, as cause of disease classified elsewhere (K.)
- Infection, infected, infective › Klebsiellapneumoniae NEC › as cause of disease classified elsewhere (opportunistic)
- Infection, infected, infective › bacterial NOS › as cause of disease classified elsewhere › Klebsiella pneumoniae [K. pneumoniae] (opportunistic)
Use additional code — inherited from Chapter 1
Report an additional code alongside B96.1 to fully describe the condition. B96.1 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 B96.1, but a patient may have both at the same time. When documentation supports it, B96.1 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 B96.1 existed?
B96.1 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 B96 family? (8)
- B96.0Mycoplasma pneumoniae [M. pneumoniae] as the cause of diseases classified elsewhere
- B96.2Escherichia coli [E. coli ] as the cause of diseases classified elsewherenot billable
- B96.3Hemophilus influenzae [H. influenzae] as the cause of diseases classified elsewhere
- B96.4Proteus (mirabilis) (morganii) as the cause of diseases classified elsewhere
- B96.5Pseudomonas (aeruginosa) (mallei) (pseudomallei) as the cause of diseases classified elsewhere
- B96.6Bacteroides fragilis [B. fragilis] as the cause of diseases classified elsewhere
- B96.7Clostridium perfringens [C. perfringens] as the cause of diseases classified elsewhere
- B96.8Other specified bacterial agents as the cause of diseases classified elsewherenot billable