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ICD-10 Guide
ICD-10 CodesB36.9

B36.9

Superficial mycosis, unspecified

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

Code Description

ICD-10 B36.9 is a billable code used to indicate a diagnosis of superficial mycosis, unspecified.

Key Diagnostic Point:

Superficial mycosis refers to a group of fungal infections that primarily affect the outer layers of the skin, hair, and nails. These infections are typically caused by dermatophytes, yeasts, or non-dermatophyte molds. Common manifestations include tinea (ringworm), candidiasis, and other fungal skin infections. The term 'unspecified' indicates that the specific type of superficial mycosis has not been identified or documented. Patients may present with symptoms such as itching, redness, scaling, and lesions on the skin or nails. Diagnosis is often made through clinical examination and may be supported by laboratory tests, including KOH preparations or fungal cultures. Treatment typically involves topical or systemic antifungal agents, depending on the severity and extent of the infection. In immunocompromised patients, such as those with HIV/AIDS, diabetes, or undergoing chemotherapy, the risk of superficial mycosis increases, and infections may be more severe or resistant to standard treatments. Therefore, careful management and monitoring are essential in these populations.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of fungal pathogens that can cause superficial mycosis.
  • Need for precise documentation to specify the type of mycosis.
  • Differentiation from other skin conditions that may mimic fungal infections.
  • Potential for co-infections in immunocompromised patients.

Audit Risk Factors

  • Inadequate documentation of the specific type of mycosis.
  • Failure to note immunocompromised status of the patient.
  • Misclassification of fungal infections as bacterial or viral.
  • Lack of follow-up documentation on treatment response.

Specialty Focus

Medical Specialties

Dermatology

Documentation Requirements

Detailed clinical notes describing the lesion characteristics, location, and any diagnostic tests performed.

Common Clinical Scenarios

Diagnosis and treatment of tinea corporis, tinea pedis, and candidiasis.

Billing Considerations

Ensure to document any underlying conditions that may predispose the patient to fungal infections.

Infectious Disease

Documentation Requirements

Comprehensive patient history, including immunocompromised status and previous infections.

Common Clinical Scenarios

Management of recurrent fungal infections in immunocompromised patients.

Billing Considerations

Consideration of systemic antifungal therapy and monitoring for drug interactions.

Coding Guidelines

Inclusion Criteria

Use B36.9 When
  • Follow official ICD
  • 10 coding guidelines, ensuring that the diagnosis is supported by clinical documentation

Exclusion Criteria

Do NOT use B36.9 When
  • Exclude conditions that are more specific or have distinct codes

Related CPT Codes

87210CPT Code

Fungal culture, any source

Clinical Scenario

Used when a fungal infection is suspected and a culture is taken.

Documentation Requirements

Document the site of culture and clinical suspicion of fungal infection.

Specialty Considerations

Dermatology and Infectious Disease specialists should ensure cultures are properly labeled and processed.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of fungal infections, but the use of unspecified codes like B36.9 can lead to challenges in treatment and reimbursement. Accurate documentation is crucial to support the use of this code.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of fungal infections, but the use of unspecified codes like B36.9 can lead to challenges in treatment and reimbursement. Accurate documentation is crucial to support the use of this code.

Reimbursement & Billing Impact

reimbursement. Accurate documentation is crucial to support the use of this code.

Resources

Clinical References

  • •
    CDC Fungal Diseases

Coding & Billing References

  • •
    CDC Fungal Diseases

Frequently Asked Questions

When should I use B36.9 instead of a more specific code?

Use B36.9 when the specific type of superficial mycosis is not documented or confirmed. Ensure that all clinical details are captured to support this coding choice.