ICD-10-CM Code For Diphtheria: Group Overview

The International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) code group A36 includes diagnoses for diphtheria, covering respiratory diphtheria, cutaneous diphtheria, and diphtheritic complications such as myocarditis and neuritis. These ICD-10-CM diagnosis codes are used to document clinical presentations of toxin-mediated infection, specifying affected anatomic sites and complication status to capture disease severity and treatment complexity. Accurate coding within the ICD-10-CM A36 group supports proper claim adjudication, complete clinical documentation, and appropriate reimbursement.

Customize your policy alerts

Sign up for ICD-10-CM Code For Diphtheria: Group Overview policy alerts

Get alerted when relevant policies change without checking for updates manually.

Monitor payer policy activity

Receive email alerts as soon as relevant payer policies are published or updated.

ICD-10-CM A36: Diphtheria Overview

The ICD-10-CM A36 group represents clinical diagnoses of diphtheria, a bacterial infection primarily affecting the upper respiratory tract and occasionally the skin. These codes capture different anatomic sites and complications of Corynebacterium diphtheriae infection and its systemic effects. Accurate coding is important to reflect disease severity and support appropriate reimbursement through complete documentation.

When to Use

Use a code from this group when a patient has a confirmed or clinically diagnosed diphtheria infection affecting the respiratory tract, skin, or when diphtheritic complications such as myocarditis or neuritis are present. Select the specific code that corresponds to the documented anatomic site and any associated complications to ensure accurate clinical and billing records.

ICD-10-CM Codes

12 rows

ICD-10-CM Code	Description
A36.0	Pharyngeal diphtheria
A36.1	Nasopharyngeal diphtheria
A36.2	Laryngeal diphtheria
A36.3	Cutaneous diphtheria
A36.81	Diphtheritic cardiomyopathy
A36.82	Diphtheritic radiculomyelitis
A36.83	Diphtheritic polyneuritis
A36.84	Diphtheritic tubulo-interstitial nephropathy
A36.85	Diphtheritic cystitis
A36.86	Diphtheritic conjunctivitis
A36.89	Other diphtheritic complications
A36.9	Diphtheria, unspecified

DRG Codes

18 rows

DRG Code	Description
011	Tracheostomy for Face, Mouth and Neck Diagnoses or Laryngectomy with MCC
012	Tracheostomy for Face, Mouth and Neck Diagnoses or Laryngectomy with CC
013	Tracheostomy for Face, Mouth and Neck Diagnoses or Laryngectomy without CC/MCC
124	Other Disorders of the Eye with MCC or Thrombolytic Agent
125	Other Disorders of the Eye without MCC
154	Other Ear, Nose, Mouth and Throat Diagnoses with MCC
155	Other Ear, Nose, Mouth and Throat Diagnoses with CC
156	Other Ear, Nose, Mouth and Throat Diagnoses without CC/MCC
314	Other Circulatory System Diagnoses with MCC
315	Other Circulatory System Diagnoses with CC
316	Other Circulatory System Diagnoses without CC/MCC
606	Minor Skin Disorders with MCC
607	Minor Skin Disorders without MCC
689	Kidney and Urinary Tract Infections with MCC
690	Kidney and Urinary Tract Infections without MCC
867	Other Infectious and Parasitic Diseases Diagnoses with MCC
868	Other Infectious and Parasitic Diseases Diagnoses with CC
869	Other Infectious and Parasitic Diseases Diagnoses without CC/MCC

Typical Clinical Scenarios

An adult presents to the emergency department with fever, sore throat, cervical lymphadenopathy, and a grayish pseudomembrane on the tonsils causing partial airway obstruction after a recent travel history to an area with low vaccination coverage. The patient is acutely ill, requires airway assessment and prompt antimicrobial therapy, and the diagnosis is assigned based on clinical findings and laboratory confirmation of Corynebacterium diphtheriae infection. Typical codes: A36.0, A36.1
A child is seen in outpatient infectious disease follow-up for resolved respiratory symptoms but persistent cutaneous ulcerative lesions where diphtheria toxin was isolated from wound culture; the lesions are chronic and require local wound care and monitoring for systemic effects. Because the infection is localized to the skin with laboratory identification of the organism, a code for cutaneous diphtheria is used to document the ongoing infectious process. Typical codes: A36.81, A36.82
An older adult hospitalized for myocarditis and peripheral neuropathy that developed as complications two weeks after an acute diphtheria respiratory infection; the patient requires cardiac monitoring and rehabilitation for neurologic deficits. A code indicating diphtheria with systemic complication(s) is assigned to capture the causal infectious etiology of the cardiac and neurologic complications. Typical codes: A36.3, A36.84, A36.85

Related Codes

A30-LEPROSY-HANSEN-S-DISEASE

ICD-10-CM Code For Leprosy Hansen's Disease: Group Overview

A31-INFECTION-DUE-TO-OTHER-MYCOBACTERIA

ICD-10-CM Code For Infection Due To Other Mycobacteria: Group Overview

A32-LISTERIOSIS

ICD-10-CM Code For Listeriosis: Group Overview

A33-TETANUS-NEONATORUM

ICD-10-CM Code For Tetanus Neonatorum: Group Overview

A34-OBSTETRICAL-TETANUS

ICD-10-CM Code For Obstetrical Tetanus: Group Overview

A35-OTHER-TETANUS

ICD-10-CM Code For Other Tetanus: Group Overview

A37-WHOOPING-COUGH

ICD-10-CM Code For Whooping Cough: Group Overview

A38-SCARLET-FEVER

ICD-10-CM Code For Scarlet Fever: Group Overview

A39-MENINGOCOCCAL-INFECTION

ICD-10-CM Code For Meningococcal Infection: Group Overview

A41-OTHER-SEPSIS

ICD-10-CM Code For Other Sepsis: Group Overview

Showing 1–10 of 16

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Explore openpayer tools

View all tools

When to Use

ICD-10-CM Codes

12 rows

ICD-10-CM Code	Description
A36.0	Pharyngeal diphtheria
A36.1	Nasopharyngeal diphtheria
A36.2	Laryngeal diphtheria
A36.3	Cutaneous diphtheria
A36.81	Diphtheritic cardiomyopathy
A36.82	Diphtheritic radiculomyelitis
A36.83	Diphtheritic polyneuritis
A36.84	Diphtheritic tubulo-interstitial nephropathy
A36.85	Diphtheritic cystitis
A36.86	Diphtheritic conjunctivitis
A36.89	Other diphtheritic complications
A36.9	Diphtheria, unspecified

DRG Codes

18 rows

DRG Code	Description
011	Tracheostomy for Face, Mouth and Neck Diagnoses or Laryngectomy with MCC
012	Tracheostomy for Face, Mouth and Neck Diagnoses or Laryngectomy with CC
013	Tracheostomy for Face, Mouth and Neck Diagnoses or Laryngectomy without CC/MCC
124	Other Disorders of the Eye with MCC or Thrombolytic Agent
125	Other Disorders of the Eye without MCC
154	Other Ear, Nose, Mouth and Throat Diagnoses with MCC
155	Other Ear, Nose, Mouth and Throat Diagnoses with CC
156	Other Ear, Nose, Mouth and Throat Diagnoses without CC/MCC
314	Other Circulatory System Diagnoses with MCC
315	Other Circulatory System Diagnoses with CC
316	Other Circulatory System Diagnoses without CC/MCC
606	Minor Skin Disorders with MCC
607	Minor Skin Disorders without MCC
689	Kidney and Urinary Tract Infections with MCC
690	Kidney and Urinary Tract Infections without MCC
867	Other Infectious and Parasitic Diseases Diagnoses with MCC
868	Other Infectious and Parasitic Diseases Diagnoses with CC
869	Other Infectious and Parasitic Diseases Diagnoses without CC/MCC

Typical Clinical Scenarios

An adult presents to the emergency department with fever, sore throat, cervical lymphadenopathy, and a grayish pseudomembrane on the tonsils causing partial airway obstruction after a recent travel history to an area with low vaccination coverage. The patient is acutely ill, requires airway assessment and prompt antimicrobial therapy, and the diagnosis is assigned based on clinical findings and laboratory confirmation of Corynebacterium diphtheriae infection. Typical codes: A36.0, A36.1
A child is seen in outpatient infectious disease follow-up for resolved respiratory symptoms but persistent cutaneous ulcerative lesions where diphtheria toxin was isolated from wound culture; the lesions are chronic and require local wound care and monitoring for systemic effects. Because the infection is localized to the skin with laboratory identification of the organism, a code for cutaneous diphtheria is used to document the ongoing infectious process. Typical codes: A36.81, A36.82
An older adult hospitalized for myocarditis and peripheral neuropathy that developed as complications two weeks after an acute diphtheria respiratory infection; the patient requires cardiac monitoring and rehabilitation for neurologic deficits. A code indicating diphtheria with systemic complication(s) is assigned to capture the causal infectious etiology of the cardiac and neurologic complications. Typical codes: A36.3, A36.84, A36.85

Related Codes

A30-LEPROSY-HANSEN-S-DISEASE

ICD-10-CM Code For Leprosy Hansen's Disease: Group Overview

A31-INFECTION-DUE-TO-OTHER-MYCOBACTERIA

ICD-10-CM Code For Infection Due To Other Mycobacteria: Group Overview

A32-LISTERIOSIS

ICD-10-CM Code For Listeriosis: Group Overview

A33-TETANUS-NEONATORUM

ICD-10-CM Code For Tetanus Neonatorum: Group Overview

A34-OBSTETRICAL-TETANUS

ICD-10-CM Code For Obstetrical Tetanus: Group Overview

A35-OTHER-TETANUS

ICD-10-CM Code For Other Tetanus: Group Overview

A37-WHOOPING-COUGH

ICD-10-CM Code For Whooping Cough: Group Overview

A38-SCARLET-FEVER

ICD-10-CM Code For Scarlet Fever: Group Overview

A39-MENINGOCOCCAL-INFECTION

ICD-10-CM Code For Meningococcal Infection: Group Overview

A41-OTHER-SEPSIS

ICD-10-CM Code For Other Sepsis: Group Overview

Showing 1–10 of 16

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

ICD-10-CM Code For Diphtheria: Group Overview

Sign up for ICD-10-CM Code For Diphtheria: Group Overview policy alerts

ICD-10-CM A36: Diphtheria Overview

ICD-10-CM Code For Diphtheria: Group Overview

Sign up for ICD-10-CM Code For Diphtheria: Group Overview policy alerts

ICD-10-CM A36: Diphtheria Overview

When to Use

ICD-10-CM Codes

DRG Codes

Typical Clinical Scenarios

Related Codes

Which ICD-10-CM codes are included in the A36 diphtheria group?

How do the A36 codes capture disease severity for billing purposes?

Which diphtheritic complications have specific ICD-10-CM codes in this group?

What DRGs might be relevant when coding for diphtheria diagnoses in A36?

How should coders document diphtheria in medical records to support reimbursement?

References

When to Use

ICD-10-CM Codes

DRG Codes

Typical Clinical Scenarios

Related Codes

Which ICD-10-CM codes are included in the A36 diphtheria group?

How do the A36 codes capture disease severity for billing purposes?

Which diphtheritic complications have specific ICD-10-CM codes in this group?

What DRGs might be relevant when coding for diphtheria diagnoses in A36?

How should coders document diphtheria in medical records to support reimbursement?

References