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v1.0.0
ICD-10 Guide
ICD-10 CodesB05

B05

Measles

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

Code Description

ICD-10 B05 is a billable code used to indicate a diagnosis of measles.

Key Diagnostic Point:

Measles, also known as rubeola, is a highly contagious viral infection caused by the measles virus, a member of the Paramyxoviridae family. It is characterized by a prodromal phase that includes high fever, cough, coryza, and conjunctivitis, followed by a distinctive maculopapular rash that typically appears 3 to 5 days after the onset of symptoms. The rash usually starts on the face and spreads downward to the rest of the body. Measles is transmitted through respiratory droplets and can remain infectious on surfaces for several hours. Vaccination with the measles, mumps, and rubella (MMR) vaccine is the most effective preventive measure, with the first dose recommended at 12-15 months of age and a second dose at 4-6 years. Complications of measles can include diarrhea, otitis media, and more severe outcomes such as pneumonia and encephalitis, particularly in malnourished children or those with weakened immune systems. The World Health Organization emphasizes the importance of vaccination to prevent outbreaks, as measles can lead to significant morbidity and mortality, especially in vulnerable populations.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between measles and other viral exanthems
  • Understanding vaccination history and its impact on coding
  • Identifying complications that may require additional codes
  • Documenting the clinical presentation accurately

Audit Risk Factors

  • Inadequate documentation of vaccination status
  • Failure to document complications or co-morbidities
  • Misclassification of the type of viral infection
  • Inconsistent coding of related conditions

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Complete vaccination history, detailed symptom description, and any complications.

Common Clinical Scenarios

Routine check-ups, acute presentations of measles, and follow-ups for complications.

Billing Considerations

Ensure accurate age-related coding and consider the impact of immunization schedules.

Infectious Disease

Documentation Requirements

Thorough clinical evaluation, laboratory confirmation of measles, and documentation of any secondary infections.

Common Clinical Scenarios

Management of measles outbreaks, treatment of complications, and immunocompromised patients.

Billing Considerations

Focus on detailed documentation of the patient's immune status and any co-infections.

Coding Guidelines

Inclusion Criteria

Use B05 When
  • According to the ICD
  • CM coding guidelines, B05 should be used for confirmed cases of measles

Exclusion Criteria

Do NOT use B05 When
  • Exclude cases where the diagnosis is not confirmed or where the patient has received the MMR vaccine without symptoms

Related Codes

Child Codes

9 codes
B05.0
Measles with pneumonia
B05.1
Measles with encephalitis
B05.2
Measles virus encephalitis
B05.3
Measles with encephalitis
B05.4
Measles with encephalitis
B05.8
Measles with other complications
B05.81
Measles keratitis and keratoconjunctivitis
B05.89
Other measles complications
B05.9
Measles, unspecified

Related CPT Codes

90705CPT Code

Measles, mumps, and rubella (MMR) vaccine

Clinical Scenario

Administered during routine childhood vaccinations.

Documentation Requirements

Record vaccination date and any adverse reactions.

Specialty Considerations

Pediatricians should ensure accurate immunization records.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of measles and its complications, improving data accuracy and public health reporting.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of measles and its complications, improving data accuracy and public health reporting.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of measles and its complications, improving data accuracy and public health reporting.

Resources

Clinical References

  • •
    CDC Measles Information

Coding & Billing References

  • •
    CDC Measles Information

Frequently Asked Questions

What is the primary cause of measles?

Measles is caused by the measles virus, which is highly contagious and spreads through respiratory droplets.

How can measles be prevented?

Measles can be prevented through vaccination with the MMR vaccine, which is recommended for children.

What are the common complications of measles?

Common complications include diarrhea, otitis media, pneumonia, and encephalitis, particularly in vulnerable populations.