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v1.0.0
ICD-10 Guide
ICD-10 CodesB26

B26

Mumps

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

Code Description

ICD-10 B26 is a billable code used to indicate a diagnosis of mumps.

Key Diagnostic Point:

Mumps is a viral infection caused by the mumps virus, which is a member of the Paramyxoviridae family. It primarily affects the salivary glands, particularly the parotid glands, leading to their swelling and tenderness. The condition is characterized by fever, headache, muscle aches, fatigue, and loss of appetite, followed by the hallmark symptom of parotitis, which is the swelling of the parotid glands. Mumps is transmitted through respiratory droplets or direct contact with an infected person's saliva. While mumps was once a common childhood illness, the introduction of the measles, mumps, and rubella (MMR) vaccine has significantly reduced its incidence. Complications can arise, including orchitis, oophoritis, meningitis, and encephalitis, particularly in adults. Diagnosis is typically made based on clinical presentation and can be confirmed through serological testing for mumps-specific IgM antibodies or PCR testing of saliva or cerebrospinal fluid. Antiviral treatments are not typically used for mumps; management focuses on symptomatic relief, including pain control and hydration.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating mumps from other viral infections with similar symptoms.
  • Understanding the implications of vaccination status on diagnosis.
  • Identifying complications that may require additional coding.
  • Navigating documentation requirements for serological tests.

Audit Risk Factors

  • Inadequate documentation of vaccination status.
  • Failure to document complications associated with mumps.
  • Misdiagnosis due to overlapping symptoms with other viral infections.
  • Insufficient detail in clinical notes regarding laboratory confirmation.

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Documentation should include vaccination history, clinical symptoms, and any complications.

Common Clinical Scenarios

Pediatric patients presenting with parotitis and fever.

Billing Considerations

Consideration of the patient's vaccination status and potential for complications.

Infectious Disease

Documentation Requirements

Detailed documentation of laboratory tests and clinical findings.

Common Clinical Scenarios

Adult patients with complications such as orchitis or meningitis.

Billing Considerations

Need for thorough differential diagnosis to rule out other viral infections.

Coding Guidelines

Inclusion Criteria

Use B26 When
  • According to the official coding guidelines, B26 should be used when a patient is diagnosed with mumps, confirmed by clinical presentation or laboratory testing

Exclusion Criteria

Do NOT use B26 When
  • Exclusion criteria include other viral infections that may present similarly

Related Codes

Child Codes

12 codes
B26.0
Mumps orchitis
B26.1
Mumps orchitis
B26.2
Herpesviral gingivostomatitis and pharyngotonsillitis
B26.3
Erysipelas caused by Streptococcus pyogenes
B26.8
Mumps due to other specified mumps virus strains
B26.81
Mumps hepatitis
B26.82
Mumps myocarditis
B26.83
Mumps nephritis
B26.84
Mumps polyneuropathy
B26.85
Mumps arthritis
B26.89
Other mumps complications
B26.9
Mumps, unspecified

Related CPT Codes

86765CPT Code

Mumps antibody test

Clinical Scenario

Used to confirm mumps infection in symptomatic patients.

Documentation Requirements

Document the reason for testing and clinical findings.

Specialty Considerations

Pediatricians should ensure vaccination history is included.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of mumps and its complications, improving data accuracy and facilitating better tracking of outbreaks and vaccination efficacy.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of mumps and its complications, improving data accuracy and facilitating better tracking of outbreaks and vaccination efficacy.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of mumps and its complications, improving data accuracy and facilitating better tracking of outbreaks and vaccination efficacy.

Resources

Clinical References

  • •
    CDC Mumps Information

Coding & Billing References

  • •
    CDC Mumps Information

Frequently Asked Questions

What are the common symptoms of mumps?

Common symptoms include fever, headache, muscle aches, fatigue, loss of appetite, and swelling of the parotid glands.

How is mumps diagnosed?

Mumps is diagnosed based on clinical symptoms and can be confirmed with serological tests for mumps-specific IgM antibodies or PCR testing.

What complications can arise from mumps?

Complications can include orchitis, oophoritis, viral meningitis, and encephalitis, particularly in adults.