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Tuberculosis (TB) remains a significant public health concern worldwide, requiring accurate medical coding for proper diagnosis, treatment, and epidemiological tracking.
The ICD-10-CM classification system provides comprehensive codes for various types of tuberculosis infections under categories A15 through A19.
This guide explores each code category with detailed descriptions to help healthcare professionals, medical coders, and billing specialists navigate tuberculosis coding accurately.
The tuberculosis coding block (A15-A19) encompasses all forms of tuberculosis infections, from respiratory manifestations to systemic dissemination. These codes are essential for medical documentation, insurance reimbursement, and disease surveillance.
Respiratory tuberculosis represents the most common form of TB infection, primarily affecting the lungs and associated respiratory structures. This category covers all tuberculosis manifestations within the respiratory system.
ICD-10 Code | Description | Clinical Details |
A15 | Respiratory tuberculosis | General category for all TB infections affecting the respiratory system |
A15.0 | Tuberculosis of lung | Pulmonary TB involving lung parenchyma; most common form of tuberculosis with symptoms including persistent cough, hemoptysis, chest pain, and weight loss |
A15.4 | Tuberculosis of intrathoracic lymph nodes | TB infection of mediastinal, hilar, or tracheobronchial lymph nodes; may occur as primary infection or reactivation |
A15.5 | Tuberculosis of larynx, trachea and bronchus | TB affecting upper and lower airway structures; presents with hoarseness, stridor, dysphagia, and chronic cough |
A15.6 | Tuberculous pleurisy | TB infection of pleural membranes; characterized by pleuritic chest pain, pleural effusion, and restrictive lung pattern |
A15.7 | Primary respiratory tuberculosis | Initial TB infection of respiratory system, typically in previously unexposed individuals; often presents as Ghon complex |
A15.8 | Other respiratory tuberculosis | TB of respiratory structures not specifically classified elsewhere within A15 category |
A15.9 | Respiratory tuberculosis unspecified | Used when respiratory TB is confirmed but specific anatomical location is not documented |
Tuberculosis can affect various components of the central and peripheral nervous system, representing serious complications that require prompt diagnosis and treatment. These infections carry significant morbidity and mortality risks.
ICD-10 Code | Description | Clinical Details |
A17 | Tuberculosis of nervous system | General category for TB affecting brain, spinal cord, meninges, and peripheral nerves |
A17.0 | Tuberculous meningitis | TB infection of meninges; presents with headache, fever, neck stiffness, altered mental status, and cranial nerve palsies; requires urgent treatment |
A17.1 | Meningeal tuberculoma | Mass lesion of TB in meninges; may cause focal neurological deficits, seizures, or increased intracranial pressure |
A17.8 | Other tuberculosis of nervous system | Category for specified nervous system TB not classified as meningitis or meningeal tuberculoma |
A17.81 | Tuberculoma of brain and spinal cord | Space-occupying TB lesions in brain or spinal cord parenchyma; symptoms depend on location and size |
A17.82 | Tuberculous meningoencephalitis | Combined infection of meninges and brain tissue; presents with both meningeal and encephalitic features |
A17.83 | Tuberculous neuritis | TB infection causing peripheral nerve inflammation; leads to neuropathic pain, weakness, and sensory deficits |
A17.89 | Other tuberculosis of nervous system | TB of nervous system structures not otherwise specified in A17 category |
A17.9 | Tuberculosis of nervous system, unspecified | Used when nervous system TB is confirmed but specific site is not documented |
Extrapulmonary tuberculosis can affect virtually any organ system in the body. The A18 category provides detailed codes for TB infections outside the respiratory and nervous systems.
ICD-10 Code | Description | Clinical Details |
A18.0 | Tuberculosis of bones and joints | General category for skeletal TB infections |
A18.01 | Tuberculosis of spine | Pott’s disease; TB spondylitis affecting vertebral bodies, potentially causing vertebral collapse, kyphosis, and spinal cord compression |
A18.02 | Tuberculous arthritis of other joints | TB infection of synovial joints (hip, knee, ankle, wrist most common); causes chronic monoarticular arthritis |
A18.03 | Tuberculosis of other bones | TB osteomyelitis of bones other than spine; may affect long bones, ribs, skull, or other skeletal structures |
A18.09 | Other musculoskeletal tuberculosis | TB affecting muscles, tendons, bursae, or other musculoskeletal structures not specified elsewhere |
ICD-10 Code | Description | Clinical Details |
A18.1 | Tuberculosis of genitourinary system | General category for TB affecting kidneys, urinary tract, and reproductive organs |
A18.10 | Tuberculosis of genitourinary system, unspecified | Used when genitourinary TB is confirmed but specific organ involvement is not documented |
A18.11 | Tuberculosis of kidney and ureter | Renal TB; presents with sterile pyuria, hematuria, flank pain, and renal scarring; may lead to hydronephrosis |
A18.12 | Tuberculosis of bladder | TB cystitis; causes frequency, dysuria, hematuria, and reduced bladder capacity |
A18.13 | Tuberculosis of other urinary organs | TB affecting urethra or other urinary structures not specified elsewhere |
A18.14 | Tuberculosis of prostate | TB prostatitis; presents with perineal discomfort, lower urinary tract symptoms, and prostatic nodules |
A18.15 | Tuberculosis of other male genital organs | TB affecting epididymis, testis, seminal vesicles, or penis; often presents as scrotal mass |
A18.16 | Tuberculosis of cervix | TB cervicitis; may mimic cervical cancer with ulceration and bleeding |
A18.17 | Tuberculous female pelvic inflammatory disease | TB affecting fallopian tubes, ovaries, or endometrium; major cause of infertility in endemic areas |
A18.18 | Tuberculosis of other female genital organs | TB of vulva, vagina, or other female reproductive structures not specified elsewhere |
ICD-10 Code | Description | Clinical Details |
A18.2 | Tuberculous peripheral lymphadenopathy | Scrofula; TB infection of peripheral lymph nodes, most commonly cervical; presents as painless, matted lymph nodes with possible sinus tract formation |
A18.3 | Tuberculosis of intestines, peritoneum and mesenteric glands | General category for abdominal TB |
A18.31 | Tuberculous peritonitis | TB infection of peritoneum; presents with ascites, abdominal pain, fever, and weight loss; classified as wet, dry, or fibrotic types |
A18.32 | Tuberculous enteritis | TB infection of intestines; causes diarrhea, abdominal pain, obstruction, or perforation; ileocecal region most commonly affected |
A18.39 | Retroperitoneal tuberculosis | TB affecting retroperitoneal space, including lymph nodes and connective tissue |
A18.4 | Tuberculosis of skin and subcutaneous tissue | Cutaneous TB including lupus vulgaris, scrofuloderma, tuberculous chancre, and warty tuberculosis |
A18.5 | Tuberculosis of eye | General category for ocular TB |
A18.50 | Tuberculosis of eye, unspecified | Used when ocular TB is confirmed but specific structure is not documented |
A18.51 | Tuberculous episcleritis | TB inflammation of episclera; presents with sectoral redness and discomfort |
A18.52 | Tuberculous keratitis | TB infection of cornea; causes photophobia, pain, and vision impairment |
A18.53 | Tuberculous chorioretinitis | TB affecting choroid and retina; may cause vision loss and ocular complications |
A18.54 | Tuberculous iridocyclitis | TB inflammation of iris and ciliary body; presents with pain, photophobia, and decreased vision |
A18.59 | Other tuberculosis of eye | TB of ocular structures not specified elsewhere |
A18.6 | Tuberculosis of (inner) (middle) ear | TB otitis media or labyrinthitis; causes hearing loss, discharge, and potential facial nerve paralysis |
A18.7 | Tuberculosis of adrenal glands | Addison’s disease due to TB; causes adrenal insufficiency with fatigue, weight loss, and hyperpigmentation |
A18.8 | Tuberculosis of other specified organs | Category for TB affecting organs not classified elsewhere |
A18.81 | Tuberculosis of thyroid gland | Rare TB infection of thyroid; presents as thyroid nodule or mass |
A18.82 | Tuberculosis of other endocrine glands | TB affecting pituitary, parathyroid, or other endocrine organs |
A18.83 | Tuberculosis of digestive tract organs, not elsewhere classified | TB of esophagus, stomach, or other GI organs not specified in A18.3 |
A18.84 | Tuberculosis of heart | TB pericarditis or myocarditis; may cause effusion, constriction, or cardiac dysfunction |
A18.85 | Tuberculosis of spleen | TB affecting splenic parenchyma; may cause splenomegaly and systemic symptoms |
A18.89 | Tuberculosis of other sites | TB of any organ or site not specified elsewhere in ICD-10-CM |
Miliary tuberculosis represents the most severe form of TB, characterized by hematogenous dissemination of the infection throughout the body. This life-threatening condition requires immediate medical intervention.
Miliary tuberculosis is an acute form of tuberculosis where minute tubercles (1-5 mm lesions) form in multiple organs due to blood-borne dissemination of Mycobacterium tuberculosis. The term “miliary” derives from the appearance of these lesions on chest X-ray, which resemble millet seeds scattered throughout the lung parenchyma. This condition includes disseminated tuberculosis, generalized tuberculosis, and tuberculous polyserositis.
ICD-10 Code | Description | Clinical Details |
A19 | Miliary tuberculosis | General category for disseminated TB with widespread hematogenous spread |
A19.0 | Acute miliary tuberculosis of a single specified site | Acute disseminated TB predominantly affecting one organ system, though bacilli have spread hematogenously |
A19.1 | Acute miliary tuberculosis of multiple sites | Acute disseminated TB with documented involvement of multiple organ systems simultaneously |
A19.2 | Acute miliary tuberculosis, unspecified | Acute miliary TB confirmed but without specific documentation of single or multiple site involvement |
A19.8 | Other miliary tuberculosis | Chronic or subacute forms of disseminated TB not classified as acute miliary disease |
A19.9 | Miliary tuberculosis, unspecified | Used when miliary TB is confirmed but temporal course (acute vs. chronic) is not documented |
When assigning tuberculosis codes from the A15-A19 range, medical coders should consider the following:
Documentation Requirements: Accurate coding requires clear physician documentation of TB location, whether it’s active or latent, and specific anatomical structures involved.
Specificity: Always code to the highest level of specificity possible. Use unspecified codes only when documentation lacks specific anatomical detail.
Multiple Sites: When TB affects multiple organ systems, code each site separately unless a specific combination code exists (such as A19.1 for multiple-site miliary TB).
Active vs. Latent: The A15-A19 codes are for active tuberculosis. Latent TB infection uses different codes (Z22.7 for latent TB infection).
Exclusions: These codes exclude congenital tuberculosis (P37.0) and certain TB sequelae which use different code categories.
Proper tuberculosis coding serves multiple critical functions in healthcare delivery. It enables accurate epidemiological tracking of TB cases for public health surveillance, ensures appropriate reimbursement for TB diagnosis and treatment services, facilitates research into TB patterns and treatment outcomes, and supports quality metrics and infection control protocols.
Tuberculosis remains a major global health challenge, particularly in immunocompromised populations and resource-limited settings. Accurate ICD-10-CM coding from categories A15 through A19 is essential for comprehensive TB management, ensuring patients receive appropriate care while maintaining robust public health surveillance systems.
The ICD-10-CM tuberculosis coding system (A15-A19) provides a comprehensive framework for classifying all forms of TB infection. From respiratory tuberculosis to disseminated miliary disease, these codes enable precise documentation of this complex infectious disease. Healthcare professionals, medical coders, and billing specialists must understand these codes thoroughly to ensure accurate diagnosis documentation, appropriate treatment pathways, and effective public health monitoring of tuberculosis cases worldwide.
By mastering these coding categories and understanding the clinical presentations they represent, healthcare teams can contribute to improved TB care delivery and global efforts to control this persistent infectious disease.
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