Diagnostic Conditions Used to Classify Antibiotic Prescribing

ConditionICD-9-CM CodesDescription
    ARTIs for which antibiotics are indicated034, 381–383, 461–463, 475, 481–486Sinusitis, pharyngitis, tonsillitis, otitis media, mastoiditis, streptococcal sore throat, peritonsillar abscess, nonspecific pneumonia
    ARTIs for which antibiotics are not indicated460, 464–466, 480, 487–488, 490Nasopharyngitis, laryngitis/tracheitis, unspecified ARTI, bronchitis (acute and not otherwise specified), bronchiolitis, viral pneumonia, influenza
    Other respiratory conditions for which antibiotics are not definitely indicated460–519 excluding those codes above; 995.3Includes chronic sinusitis, chronic bronchitis, asthma, allergy, other respiratory conditions
Other conditions
    Skin/cutaneous/mucosal680–686, 690–698, 700–709, 870–897, 910–919, 940–949, 035, 110–111, 360–379, 380–389, 704.8, 728.0, 611.0, 771.5, 728.86Includes infections of the skin and subcutaneous tissue, inflammatory and other skin conditions, open wounds, superficial injuries, burns, erysipelas, dermatophytosis/dermatomycosis, diseases of the eye/adnexa, ear diseases other than otitis media and mastoiditis, folliculitis, infective myositis, mastitis, necrotizing fasciitis
    Urinary tract infections590.1, 590.2, 590.8, 590.9, 595.0, 595.9, 599.0Acute pyelonephritis, renal abscess, other pyelonephritis/pyelonephrosis, kidney infection (unspecified), acute cystitis, cystitis (unspecified), urinary tract infection (unspecified)
    Gastrointestinal infections001–009, 787.0, 787.91Intestinal infectious diseases, nausea/vomiting, diarrhea
    Miscellaneous infections010–018, 020–027, 030–033 036–109, 112–139, 320–323Includes tuberculosis, zoonotic diseases, diptheria, pertussis, meningitis, and miscellaneous infectious/parasitic diseases other than those of the skin and subcutaneous tissue or digestive tract
    OtherRemaining codesMiscellaneous conditions for which no infectious etiology is identified