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v1.0.0
ICD-10 Guide
ICD-10 CodesA28.2

A28.2

Disseminated histoplasmosis

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/05/2025

Code Description

ICD-10 A28.2 is a billable code used to indicate a diagnosis of disseminated histoplasmosis.

Key Diagnostic Point:

Disseminated histoplasmosis is a systemic fungal infection caused by the organism Histoplasma capsulatum, which is primarily found in soil enriched with bird or bat droppings. The infection can occur after inhalation of spores, leading to pulmonary histoplasmosis, which may progress to disseminated disease, particularly in immunocompromised individuals. Symptoms of disseminated histoplasmosis can include fever, weight loss, fatigue, cough, and respiratory distress. The disease can affect multiple organ systems, including the liver, spleen, and bone marrow, leading to complications such as anemia and thrombocytopenia. Diagnosis is typically made through clinical evaluation, serological tests, and culture of the organism. Treatment involves antifungal medications, and early intervention is crucial for improving outcomes, especially in high-risk populations such as those with HIV/AIDS or other immunosuppressive conditions.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between pulmonary and disseminated forms of histoplasmosis.
  • Identifying immunocompromised patients who may present atypically.
  • Understanding the need for laboratory confirmation versus clinical diagnosis.
  • Navigating the documentation requirements for antifungal treatment.

Audit Risk Factors

  • Inadequate documentation of clinical findings.
  • Failure to document immunocompromised status.
  • Lack of laboratory confirmation in the medical record.
  • Misclassification of the disease stage (localized vs. disseminated).

Specialty Focus

Medical Specialties

Infectious Disease

Documentation Requirements

Detailed clinical history, laboratory results, and treatment plans.

Common Clinical Scenarios

Patients presenting with fever, weight loss, and respiratory symptoms.

Billing Considerations

Ensure documentation reflects the severity and extent of the disease.

Pulmonology

Documentation Requirements

Pulmonary function tests, imaging studies, and treatment response.

Common Clinical Scenarios

Patients with respiratory distress and a history of exposure to endemic areas.

Billing Considerations

Document any pulmonary complications and response to antifungal therapy.

Coding Guidelines

Inclusion Criteria

Use A28.2 When
  • According to ICD
  • 10 guidelines, A28
  • 2 should be used when the infection is confirmed as disseminated
  • Documentation must support the diagnosis, including clinical symptoms and laboratory findings

Exclusion Criteria

Do NOT use A28.2 When
  • Exclude cases where the infection is localized or not confirmed

Related CPT Codes

87449CPT Code

Histoplasma antigen test

Clinical Scenario

Used to confirm diagnosis in suspected cases of disseminated histoplasmosis.

Documentation Requirements

Document the reason for testing and results.

Specialty Considerations

Infectious disease specialists should ensure comprehensive documentation of test results.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of disseminated histoplasmosis, improving data accuracy and facilitating better tracking of epidemiological trends.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of disseminated histoplasmosis, improving data accuracy and facilitating better tracking of epidemiological trends.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of disseminated histoplasmosis, improving data accuracy and facilitating better tracking of epidemiological trends.

Resources

Clinical References

  • •
    CDC - Histoplasmosis

Coding & Billing References

  • •
    CDC - Histoplasmosis

Frequently Asked Questions

What are the common symptoms of disseminated histoplasmosis?

Common symptoms include fever, weight loss, cough, fatigue, and respiratory distress. In severe cases, it can affect multiple organ systems.