Is A48.3 a billable ICD-10-CM code?

Yes. A48.3 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does A48.3 sit in the tabular list?

Certain infectious and parasitic diseases (A00-B99), in the block Other bacterial diseases (A30-A49).

What cannot be coded together with A48.3?

A48.3 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.

A48.3

A48.3 — Toxic shock syndrome

Billable / specific codeICD-10-CM

A48.3 is a billable, specific ICD-10-CM code for toxic shock syndrome. It is valid for submission on a claim.

Excludes1 — never code together

These conditions cannot occur together. Billing both on the same encounter is a denial.

endotoxic shock NOS (R57.8)
sepsis NOS (A41.9)

Use additional code

Add a secondary code to capture the detail described below.

code to identify the organism (B95, B96)

Other codes that can never be billed with A48.3

These codes carry an Excludes1 note pointing at A48.3. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading A48.3 alone.

R57Shock, not elsewhere classified

Risk adjustment

A48.3 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:

HCC 2 Septicemia, Sepsis, Systemic Inflammatory Response Syndrome/Shock0.500 RAF

Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score.

Medicare coverage

A48.3 is named in 2 Medicare coverage policies — 2 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A59105Billing and Coding: Off-Label Use of Intravenous Immune Globulin (IVIG)
A60187Billing and Coding: Off-Label Use of Intravenous Immune Globulin (IVIG)

How A48.3 is indexed

Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to A48.3.

Shock›toxic, syndrome
Syndrome›toxic shock
Toxic›shock syndrome
Syndrome›shock›toxic

Related codes at this level

Codes that share A48. If A48.3 is not quite right, the correct code is usually one of these.

Questions about A48.3

Is A48.3 a billable ICD-10-CM code?: Yes. A48.3 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does A48.3 sit in the tabular list?: Certain infectious and parasitic diseases (A00-B99), in the block Other bacterial diseases (A30-A49).
What cannot be coded together with A48.3?: A48.3 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.