ICD-10-CM Code For Nosocomial Condition: Group Overview

The International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) code group Y95 includes conditions acquired in connection with a stay in a healthcare facility or caused by healthcare-related factors, such as hospital-acquired infections and other facility-related complications. These ICD-10-CM diagnosis codes are used to document complications originating from the care environment, capturing the context of acquisition, affected systems, and associated clinical complexity. Accurate coding within the ICD-10-CM Y95 group supports proper claim adjudication and quality reporting.

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ICD-10-CM Y95: Nosocomial Condition Overview

The ICD-10-CM Y95 group identifies conditions that are acquired during a stay in a healthcare facility or that are caused by healthcare-associated factors. These diagnoses target complications and infections originating in the care environment rather than community onset. Accurate coding is important because it distinguishes facility-acquired conditions for clinical surveillance and can affect quality reporting and reimbursement.

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ICD-10-CM Code For Nosocomial Condition: Group Overview

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ICD-10-CM Y95: Nosocomial Condition Overview

When to Use

Use a code from this group when documentation indicates the condition was acquired during a hospital or other healthcare facility stay or is directly related to healthcare exposure. Assign these codes to capture the facility-acquired nature of the condition for clinical records, reporting, and billing purposes.

ICD-10-CM Codes

1 rows

ICD-10-CM Code	Description
Y95	Nosocomial condition

Typical Clinical Scenarios

An elderly patient in a surgical ward develops a fever and purulent drainage from the incision site three days after a hip replacement; the patient is evaluated by the inpatient team and the treating clinicians document that the infection was acquired during the current hospitalization, necessitating wound cultures and intravenous antibiotics. A code from this group is assigned to indicate the condition was nosocomial and related to care received in the hospital. Typical codes: Y95
A neonate in the neonatal intensive care unit with prolonged central venous access develops signs of sepsis and the team determines the bloodstream infection was associated with the indwelling catheter placed during this admission; the infant requires escalation of support and antimicrobial therapy. A code from this group is used to denote the infection was contracted in the healthcare setting during the current stay. Typical codes: Y95
A patient admitted for stroke rehabilitation develops a new-onset methicillin-resistant Staphylococcus aureus (MRSA) pneumonia after several days on a ventilator, complicating the recovery and lengthening the hospital stay; the attending documents the pneumonia as acquired while hospitalized. A code from this group is assigned to indicate the condition was acquired during the hospital course. Typical codes: Y95

Related Codes

Y90-EVIDENCE-OF-ALCOHOL-INVOLVEMENT

ICD-10-CM Code For Evidence Of Alcohol Involvement Determined By Blood Alcohol Level: Group Overview

Y92-PLACE-OF-OCCURRENCE

ICD-10-CM Code For Place Of Occurrence Of The External Cause: Group Overview

Y93-ACTIVITY-CODES

ICD-10-CM Code For Activity Codes: Group Overview

Y99-EXTERNAL-CAUSE-STATUS

ICD-10-CM Code For External Cause Status: Group Overview

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.

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When to Use

ICD-10-CM Codes

1 rows

ICD-10-CM Code	Description
Y95	Nosocomial condition

Typical Clinical Scenarios

An elderly patient in a surgical ward develops a fever and purulent drainage from the incision site three days after a hip replacement; the patient is evaluated by the inpatient team and the treating clinicians document that the infection was acquired during the current hospitalization, necessitating wound cultures and intravenous antibiotics. A code from this group is assigned to indicate the condition was nosocomial and related to care received in the hospital. Typical codes: Y95
A neonate in the neonatal intensive care unit with prolonged central venous access develops signs of sepsis and the team determines the bloodstream infection was associated with the indwelling catheter placed during this admission; the infant requires escalation of support and antimicrobial therapy. A code from this group is used to denote the infection was contracted in the healthcare setting during the current stay. Typical codes: Y95
A patient admitted for stroke rehabilitation develops a new-onset methicillin-resistant Staphylococcus aureus (MRSA) pneumonia after several days on a ventilator, complicating the recovery and lengthening the hospital stay; the attending documents the pneumonia as acquired while hospitalized. A code from this group is assigned to indicate the condition was acquired during the hospital course. Typical codes: Y95

Related Codes

Y90-EVIDENCE-OF-ALCOHOL-INVOLVEMENT

ICD-10-CM Code For Evidence Of Alcohol Involvement Determined By Blood Alcohol Level: Group Overview

Y92-PLACE-OF-OCCURRENCE

ICD-10-CM Code For Place Of Occurrence Of The External Cause: Group Overview

Y93-ACTIVITY-CODES

ICD-10-CM Code For Activity Codes: Group Overview

Y99-EXTERNAL-CAUSE-STATUS

ICD-10-CM Code For External Cause Status: Group Overview

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 Nosocomial Condition: Group Overview

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

ICD-10-CM Y95: Nosocomial Condition Overview

ICD-10-CM Code For Nosocomial Condition: Group Overview

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

ICD-10-CM Y95: Nosocomial Condition Overview

When to Use

ICD-10-CM Codes

Typical Clinical Scenarios

Related Codes

What does the ICD-10-CM group `Y95` identify?

Why is accurate coding of `Y95` important for providers and payers?

What types of events are documented using `Y95` codes?

How does `Y95` relate to quality reporting?

Which specific code is included in this ICD-10-CM group?

References

When to Use

ICD-10-CM Codes

Typical Clinical Scenarios

Related Codes

What does the ICD-10-CM group `Y95` identify?

Why is accurate coding of `Y95` important for providers and payers?

What types of events are documented using `Y95` codes?

How does `Y95` relate to quality reporting?

Which specific code is included in this ICD-10-CM group?

References