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v1.0.0
ICD-10 Guide
ICD-10 CodesB06.81

B06.81

Rubella pneumonia

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

Code Description

ICD-10 B06.81 is a billable code used to indicate a diagnosis of rubella pneumonia.

Key Diagnostic Point:

Rubella pneumonia is a rare but serious complication of rubella infection, primarily affecting individuals who are immunocompromised or those who have not been vaccinated against rubella. The condition arises when the rubella virus, which is typically associated with mild symptoms such as rash and fever, leads to inflammation of the lungs. Patients may present with respiratory symptoms including cough, difficulty breathing, and chest pain, alongside systemic symptoms like fever and malaise. Diagnosis is often confirmed through serological testing for rubella-specific IgM antibodies or PCR testing of respiratory secretions. Management typically involves supportive care, as there is no specific antiviral treatment for rubella pneumonia. Vaccination against rubella is crucial in preventing this condition, as the MMR (measles, mumps, rubella) vaccine has been shown to be highly effective in reducing the incidence of rubella and its associated complications. Complications from rubella pneumonia can include respiratory failure and secondary bacterial infections, which may necessitate hospitalization and further medical intervention.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Limited awareness of rubella pneumonia among healthcare providers.
  • Need for accurate serological testing to confirm diagnosis.
  • Differentiation from other viral and bacterial pneumonias.
  • Documentation of vaccination history and exposure risk.

Audit Risk Factors

  • Inadequate documentation of vaccination status.
  • Failure to document serological test results.
  • Misdiagnosis due to overlapping symptoms with other conditions.
  • Lack of clear clinical rationale for the diagnosis.

Specialty Focus

Medical Specialties

Infectious Disease

Documentation Requirements

Detailed patient history, vaccination status, and laboratory results.

Common Clinical Scenarios

Patients presenting with respiratory symptoms following rubella infection.

Billing Considerations

Consideration of immunocompromised status and potential for severe disease.

Pulmonology

Documentation Requirements

Comprehensive pulmonary function tests and imaging studies.

Common Clinical Scenarios

Patients with acute respiratory distress and a history of rubella.

Billing Considerations

Differentiation from other causes of pneumonia and respiratory failure.

Coding Guidelines

Inclusion Criteria

Use B06.81 When
  • According to ICD
  • 10 guidelines, B06
  • 81 should be used when a patient is diagnosed with pneumonia specifically attributed to rubella
  • It is essential to document the clinical findings, laboratory results, and vaccination history to support the diagnosis

Exclusion Criteria

Do NOT use B06.81 When
No specific exclusions found.

Related CPT Codes

86765CPT Code

Rubella antibody test

Clinical Scenario

Used to confirm rubella infection in patients presenting with pneumonia.

Documentation Requirements

Document the reason for testing and results.

Specialty Considerations

Infectious disease specialists should ensure comprehensive testing.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of rubella pneumonia, improving the accuracy of data collection and epidemiological tracking of this rare condition.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of rubella pneumonia, improving the accuracy of data collection and epidemiological tracking of this rare condition.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of rubella pneumonia, improving the accuracy of data collection and epidemiological tracking of this rare condition.

Resources

Clinical References

  • •
    CDC Rubella Information

Coding & Billing References

  • •
    CDC Rubella Information

Frequently Asked Questions

What are the symptoms of rubella pneumonia?

Symptoms include cough, fever, difficulty breathing, and chest pain, often accompanied by systemic symptoms like malaise.

How is rubella pneumonia diagnosed?

Diagnosis is confirmed through serological testing for rubella-specific IgM antibodies or PCR testing of respiratory secretions.

What is the treatment for rubella pneumonia?

Treatment is primarily supportive, as there is no specific antiviral therapy for rubella pneumonia.

Why is vaccination important?

Vaccination with the MMR vaccine significantly reduces the incidence of rubella and its complications, including pneumonia.