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B95.2

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🎗️ICD-10-CM B95.2 — Streptococcus Group D and Enterococcus as the Cause of Diseases Classified Elsewhere

Clinical Definition

ICD-10-CM B95.2 identifies Streptococcus group D and Enterococcus as the causative organism of a condition coded elsewhere.

These organisms are commonly found in the gastrointestinal tract, female genital tract, and the environment, and may cause disease particularly in individuals with weakened immune systems. They are associated with infections such as:

  • Urinary tract infections
  • Bloodstream infections
  • Endocarditis
  • Surgical site infections
  • Intra‑abdominal infections

This code does not describe the disease itself—it supplements another ICD‑10‑CM code by specifying that Group D Streptococcus/Enterococcus is the infectious agent.

Coding Guidance

Key Rules

  • Use B95.2 only when the provider documents Group D Streptococcus or Enterococcus as the causative organism.
  • This code cannot be used alone; it must accompany a disease code (e.g., UTI, cellulitis, endocarditis).
  • Do not use for “Streptococcus, unspecified” — use B95.5 instead.
  • Do not use for perinatal infections — use P35-P39.
  • Add Z16.- if antimicrobial resistance is documented (e.g., VRE).

Sequencing

  • Never principal diagnosis.
  • Sequence the underlying condition first, then add B95.2 to identify the organism.

Includes / Excludes

Includes

  • Streptococcus group D as causative organism
  • Enterococcus as causative organism
  • Organism identified by culture or molecular testing

Excludes

  • Streptococcus unspecified — B95.5
  • Carrier/suspected carrier — Z22.-
  • Perinatal infections — P36
  • Other bacterial agents — B96.89

Code Tree

B95-B97 Bacterial and viral infectious agents 
├── B95 Streptococcus, Staphylococcus, and Enterococcus as cause of diseases elsewhere 
│ ├── B95.0 Streptococcus, group A 
│ ├── B95.1 Streptococcus, group B 
│ ├── B95.2 Streptococcus, group D and Enterococcus 
│ ├── B95.3 Streptococcus pneumoniae 
│ ├── B95.4 Other streptococcus 
│ └── B95.5 Streptococcus, unspecified 
├── B96 Other bacterial agents 
└── B97 Viral agents

MS‑DRG Impact

Because B95.2 is a supplementary organism code, its DRG impact depends on the primary condition.
However, when paired with infectious diagnoses, it commonly maps into:

  • DRG 867 — Other infectious & parasitic diseases with MCC
  • DRG 868 — Other infectious & parasitic diseases with CC
  • DRG 869 — Other infectious & parasitic diseases without CC/MCC

These DRGs reflect the resource intensity of infections caused by Enterococcus, which is known for antimicrobial resistance and healthcare‑associated infections.

HCC Impact

  • No HCC assignment.
    This code identifies an organism only and does not represent a condition included in risk‑adjustment models.

Documentation Requirements

Provider documentation should clearly state:

  • Group D Streptococcus or Enterococcus as the causative organism
  • The underlying disease process (e.g., UTI, endocarditis, cellulitis, bacteremia)
  • Clinical evidence supporting infection
  • Culture or lab confirmation when available
  • Any antimicrobial resistance (e.g., VRE → add Z16.21)

Coding Examples

Example 1

Documentation:
“Enterococcal UTI.”

Codes:

  • N39.0 — UTI, site not specified
  • B95.2 — Enterococcus as causative organism

Example 2

Documentation:
“Group D Streptococcus bacteremia secondary to infected wound.”

Codes:

  • A49.1 — Streptococcal infection, unspecified site
  • L08.9 — Local infection of skin and subcutaneous tissue
  • B95.2 — Group D Streptococcus as cause

Example 3

Documentation:
“Enterococcal endocarditis.”

Codes:

  • I33.0 — Acute/subacute infective endocarditis
  • B95.2 — Enterococcus as causative organism

Example 4

Documentation:
“VRE (vancomycin‑resistant Enterococcus) wound infection.”

Codes:

  • Underlying wound infection code (e.g., L08.9)
  • B95.2 — Enterococcus as cause
  • Z16.21 — Resistance to vancomycin
  • B95.0 — Streptococcus group A
  • B95.1 — Streptococcus group B
  • B95.5 — Streptococcus unspecified
  • B96.89 — Other specified bacterial agents
  • Z16.- — Antimicrobial resistance

Notes for Auditors & Coders

  • Confirm that the organism is Group D Streptococcus or Enterococcus, not unspecified streptococcus.
  • Ensure the underlying condition is coded first.
  • Do not assign B95.2 when the disease code already includes the organism (e.g., certain streptococcal sepsis codes).
  • Query when documentation is unclear regarding organism identification or resistance patterns.

Sources

ICD‑10‑CM B95.2 organism definition
Enterococcus clinical relevance and infection patterns
DRG grouping for infectious diseases

Graph View

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