ICD-10 · PDGM grouping
A04 Other bacterial intestinal infections
All 11 codes in the A04 family, with the PDGM clinical group, comorbidity subgroup and primary-position rule CMS assigns, read from the CMS grouper crosswalk v07.2.26 and the CDC FY2027 code file.
Codes in family
11
Can lead a claim
11
Cannot lead a claim
0
What CMS assigns to A04
All 11 codes group to MMTA - Infectious Disease, Neoplasms, and Blood-Forming Diseases. 2 of the 11 count toward the C-diff, MRSA, E-coli, Sepsis comorbidity subgroup; 9 are assigned none. Every code can lead a claim.
- C-diff, MRSA, E-coli, Sepsis: counts toward the high comorbidity tier only in an interaction pair.
Every code in A04
Descriptions are CDC’s FY2027 wording; where CMS’s grouper abbreviates one, its form is shown beneath.
| Code | Description | Primary position | Clinical group | Comorbidity subgroup |
|---|---|---|---|---|
| A04.0 | Enteropathogenic Escherichia coli infection | Can lead a claim | K | None |
| A04.1 | Enterotoxigenic Escherichia coli infection | Can lead a claim | K | None |
| A04.2 | Enteroinvasive Escherichia coli infection | Can lead a claim | K | None |
| A04.3 | Enterohemorrhagic Escherichia coli infection | Can lead a claim | K | None |
| A04.4 | Other intestinal Escherichia coli infections | Can lead a claim | K | None |
| A04.5 | Campylobacter enteritis | Can lead a claim | K | None |
| A04.6 | Enteritis due to Yersinia enterocolitica | Can lead a claim | K | None |
| A04.7 Enterocolitis due to Clostridium difficile | ||||
| A04.71 | Enterocolitis due to Clostridium difficile, recurrent | Can lead a claim | K | C-diff, MRSA, E-coli, Sepsis |
| A04.72 | Enterocolitis due to Clostridium difficile, not specified as recurrentCMS: Enterocolitis d/t Clostridium difficile, not spcf as recur | Can lead a claim | K | C-diff, MRSA, E-coli, Sepsis |
| A04.8 | Other specified bacterial intestinal infections | Can lead a claim | K | None |
| A04.9 | Bacterial intestinal infection, unspecified | Can lead a claim | K | None |
Sources: CMS HH PPS Grouper Software v07.2.26, effective 2026-10-01, for the clinical group, comorbidity subgroup, code-first conventions and primary-position flags; CDC NCHS ICD-10-CM FY2027 code descriptions for the family title and code wording. This is the crosswalk Medicare runs a claim through. Grouping also depends on admission source, timing, the OASIS functional items and the rest of the diagnosis list.
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