ICD-10 Code for Recent Mycoplasma Genitalium Infection
The appropriate ICD-10 code for recent Mycoplasma genitalium infection is A63.8 (Other specified predominantly sexually transmitted diseases). This code should be used when documenting a confirmed Mycoplasma genitalium infection since there is no specific ICD-10 code exclusively for this organism.
Background on Mycoplasma Genitalium
- Mycoplasma genitalium is recognized as an emerging sexually transmitted pathogen that contributes to 10-35% of non-chlamydial non-gonococcal urethritis in men and is associated with cervicitis and pelvic inflammatory disease (PID) in 10-25% of women 1, 2
- Transmission occurs through direct mucosal contact, and asymptomatic infections are frequent 1, 2
- M. genitalium is now established as an important cause of persistent and recurrent non-gonococcal urethritis (NGU) in men 3
Clinical Presentation
- In men, M. genitalium infection typically presents as urethritis with symptoms including dysuria and urethral discharge 1, 2
- In women, symptoms may include vaginal discharge, dysuria, or symptoms of PID such as abdominal pain and dyspareunia 1, 2
- M. genitalium can be asymptomatic in both men and women, making it difficult to diagnose without specific testing 4
Diagnostic Considerations
- Diagnosis of M. genitalium is achievable only through nucleic acid amplification testing (NAAT), as the organism is difficult to isolate in culture 1, 2
- Testing should ideally include investigation for macrolide resistance mutations, which are increasingly common 2
- Recent surveillance data indicates macrolide resistance prevalence of 59.1% in the United States, suggesting azithromycin should not be used without resistance testing 5
Coding Guidance
- Since there is no specific ICD-10 code for Mycoplasma genitalium, the appropriate code is A63.8 (Other specified predominantly sexually transmitted diseases)
- When documenting, it is important to specify "Mycoplasma genitalium infection" in the clinical notes to ensure clarity
- Additional symptom-based codes may be used as secondary codes to document specific manifestations (e.g., urethritis, cervicitis, PID)
Treatment Considerations
- First-line treatment for uncomplicated M. genitalium without macrolide resistance: Azithromycin 500 mg on day one, then 250 mg on days 2-5 2
- Second-line treatment and treatment for macrolide-resistant infection: Moxifloxacin 400 mg once daily for 7 days 2
- For complicated infections such as PID or epididymitis: Moxifloxacin 400 mg once daily for 14 days 2