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ICD-10 Guide
ICD-10 CodesB27.0

B27.0

Infectious mononucleosis

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

Code Description

ICD-10 B27.0 is a billable code used to indicate a diagnosis of infectious mononucleosis.

Key Diagnostic Point:

Infectious mononucleosis, commonly known as mono, is primarily caused by the Epstein-Barr virus (EBV), a member of the herpesvirus family. This viral infection is characterized by fever, sore throat, swollen lymph nodes, and fatigue. The disease is most prevalent among adolescents and young adults, although it can affect individuals of any age. The transmission of EBV occurs through saliva, which is why it is often referred to as the 'kissing disease.' Diagnosis typically involves clinical evaluation and laboratory tests, including heterophile antibody tests (such as the Monospot test) and specific EBV serologies to confirm the presence of the virus. While most cases are self-limiting, symptomatic treatment is often required, including hydration, analgesics, and rest. In severe cases, corticosteroids may be prescribed to reduce inflammation. Understanding the clinical presentation and diagnostic criteria is crucial for accurate coding and management of the condition.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation among patients
  • Need for laboratory confirmation of EBV infection
  • Differentiation from other similar conditions (e.g., streptococcal pharyngitis)
  • Potential for complications such as splenic rupture

Audit Risk Factors

  • Inadequate documentation of symptoms leading to misdiagnosis
  • Failure to document laboratory test results
  • Coding without confirming the specific viral etiology
  • Inconsistent treatment documentation

Specialty Focus

Medical Specialties

Primary Care

Documentation Requirements

Detailed patient history, physical examination findings, and results of laboratory tests.

Common Clinical Scenarios

Patients presenting with fatigue, sore throat, and lymphadenopathy.

Billing Considerations

Ensure documentation reflects the clinical decision-making process and any differential diagnoses considered.

Infectious Disease

Documentation Requirements

Comprehensive evaluation of the patient's history, including exposure risks and serological testing results.

Common Clinical Scenarios

Patients with atypical presentations or complications from infectious mononucleosis.

Billing Considerations

Document any additional diagnostic tests performed and their results to support coding.

Coding Guidelines

Inclusion Criteria

Use B27.0 When
  • According to ICD
  • 10 coding guidelines, B27
  • 0 should be used when the diagnosis of infectious mononucleosis is confirmed through clinical evaluation and laboratory testing

Exclusion Criteria

Do NOT use B27.0 When
  • Exclusion criteria include other viral infections that may present similarly, such as cytomegalovirus or HIV

Related CPT Codes

86790CPT Code

EBV antibody test

Clinical Scenario

When laboratory confirmation of EBV is required.

Documentation Requirements

Document the reason for the test and the results.

Specialty Considerations

Infectious disease specialists may order additional serological tests.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of infectious mononucleosis, improving the accuracy of data collection and reimbursement processes. This specificity aids in better tracking of disease prevalence and outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of infectious mononucleosis, improving the accuracy of data collection and reimbursement processes. This specificity aids in better tracking of disease prevalence and outcomes.

Reimbursement & Billing Impact

reimbursement processes. This specificity aids in better tracking of disease prevalence and outcomes.

Resources

Clinical References

  • •
    CDC - Infectious Mononucleosis

Coding & Billing References

  • •
    CDC - Infectious Mononucleosis

Frequently Asked Questions

What are the common symptoms of infectious mononucleosis?

Common symptoms include fever, sore throat, swollen lymph nodes, and fatigue. Some patients may also experience headaches, rash, and abdominal pain.

How is infectious mononucleosis diagnosed?

Diagnosis is typically made through clinical evaluation and laboratory tests, including the Monospot test and specific EBV serologies.

What treatments are available for infectious mononucleosis?

Treatment is primarily supportive, focusing on hydration, rest, and pain relief. Corticosteroids may be used in severe cases.