Coding and coverage · ICD-10-CM

A54

A54.5 Gonococcal pharyngitis

BillableNo payment HCCChapter 1

Instructional notes

Chapter 1

Excludes2Not included here: the patient may have both; report both when both are present.
  • 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)
Use additional codeAdd a second code for the full picture.
  • code to identify resistance to antimicrobial drugs (Z16.-)
Includes
  • diseases generally recognized as communicable or transmissible

Section A50-A64

Excludes1Not coded here: never report with this code, except when the two conditions are unrelated.
  • nonspecific and nongonococcal urethritis (N34.1)
  • Reiter's disease (M02.3-)
Excludes2Not included here: the patient may have both; report both when both are present.
  • human immunodeficiency virus [HIV] disease (B20)

Chapter 1: Certain infectious and parasitic diseases · A50-A64 Infections with a predominantly sexual mode of transmission (A50-A64)

Source: ICD-10-CM FY 2027 code descriptions and tabular list (CMS and CDC National Center for Health Statistics), effective 2026-10-01 through 2027-09-30 · CMS ICD-10 files. HCC mapping: CMS-HCC V28, payment year 2027. As of 2026-11-04.

Coverage and payment depend on the claim details; confirm with the Medicare Administrative Contractor.