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v1.0.0
ICD-10 Guide
ICD-10 CodesB26.85

B26.85

Mumps arthritis

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

Code Description

ICD-10 B26.85 is a billable code used to indicate a diagnosis of mumps arthritis.

Key Diagnostic Point:

Mumps arthritis is an inflammatory condition that occurs as a complication of mumps virus infection. The mumps virus, a member of the Paramyxoviridae family, primarily affects the salivary glands, but it can also lead to systemic complications, including arthritis. This condition is characterized by joint pain and swelling, typically affecting the knees, wrists, and ankles. The onset of arthritis usually occurs after the initial symptoms of mumps, such as fever, headache, and parotitis, have resolved. Diagnosis is primarily clinical, supported by serological tests that detect mumps-specific IgM antibodies or a rise in IgG titers. While mumps arthritis is generally self-limiting, symptomatic treatment may include nonsteroidal anti-inflammatory drugs (NSAIDs) to alleviate pain and inflammation. In rare cases, corticosteroids may be prescribed for severe symptoms. Vaccination against mumps is the most effective preventive measure, significantly reducing the incidence of the disease and its complications.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating mumps arthritis from other viral or autoimmune arthritides.
  • Need for serological confirmation of mumps infection.
  • Potential for co-occurring conditions that may complicate coding.
  • Variability in clinical presentation and severity of symptoms.

Audit Risk Factors

  • Inadequate documentation of serological test results.
  • Failure to document the clinical correlation between mumps and arthritis.
  • Misclassification of mumps arthritis as a primary condition without supporting evidence.
  • Inconsistent coding of co-existing conditions.

Specialty Focus

Medical Specialties

Rheumatology

Documentation Requirements

Detailed clinical notes on joint examination findings and serological test results.

Common Clinical Scenarios

Patients presenting with joint pain following a recent mumps infection.

Billing Considerations

Consideration of differential diagnoses such as reactive arthritis or other viral arthritides.

Infectious Disease

Documentation Requirements

Comprehensive history of mumps exposure and vaccination status.

Common Clinical Scenarios

Patients with confirmed mumps infection presenting with joint symptoms.

Billing Considerations

Documentation of laboratory confirmation of mumps virus infection.

Coding Guidelines

Inclusion Criteria

Use B26.85 When
  • According to ICD
  • 10 guidelines, B26
  • 85 should be used when there is a confirmed diagnosis of mumps arthritis, supported by clinical and laboratory findings

Exclusion Criteria

Do NOT use B26.85 When
  • Exclusion criteria include other viral or autoimmune arthritides that may mimic mumps arthritis

Related CPT Codes

86735CPT Code

Mumps antibody test

Clinical Scenario

Used to confirm mumps infection in patients presenting with arthritis.

Documentation Requirements

Document the reason for testing and the clinical findings leading to the test.

Specialty Considerations

Infectious disease specialists should ensure comprehensive documentation of the patient's history.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of mumps-related complications, including mumps arthritis, improving the accuracy of epidemiological data and treatment tracking.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of mumps-related complications, including mumps arthritis, improving the accuracy of epidemiological data and treatment tracking.

Reimbursement & Billing Impact

reimbursement.

Resources

Clinical References

  • •
    CDC Mumps Information

Coding & Billing References

  • •
    CDC Mumps Information

Frequently Asked Questions

What are the common symptoms of mumps arthritis?

Common symptoms include joint pain, swelling, and stiffness, typically affecting the knees, wrists, and ankles, occurring after the initial mumps infection.