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v1.0.0
ICD-10 Guide
ICD-10 CodesB37.49

B37.49

Other urogenital candidiasis

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

Code Description

ICD-10 B37.49 is a billable code used to indicate a diagnosis of other urogenital candidiasis.

Key Diagnostic Point:

Other urogenital candidiasis refers to fungal infections caused by Candida species that affect the urogenital tract, excluding the more common forms such as vulvovaginal candidiasis. This condition can manifest in various ways, including urethritis, cystitis, and other infections of the urinary tract and genital area. Patients may present with symptoms such as itching, burning, and abnormal discharge. The condition is particularly prevalent in immunocompromised individuals, such as those with HIV/AIDS, diabetes, or those undergoing immunosuppressive therapy. Diagnosis typically involves clinical evaluation and laboratory tests, including culture and sensitivity testing to identify the specific Candida species involved. Treatment usually involves antifungal medications, such as fluconazole or topical agents, and may require adjustments based on the patient's immune status and the severity of the infection. Understanding the nuances of this condition is crucial for accurate coding and effective treatment planning.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of clinical presentations and symptoms
  • Differentiation from other urogenital infections
  • Need for laboratory confirmation of Candida species
  • Consideration of patient’s immunocompromised status

Audit Risk Factors

  • Inadequate documentation of symptoms and clinical findings
  • Failure to document laboratory results confirming Candida infection
  • Misclassification of the infection type
  • Lack of detail regarding the patient's immunocompromised status

Specialty Focus

Medical Specialties

Infectious Disease

Documentation Requirements

Detailed clinical notes on symptoms, laboratory results, and treatment plans.

Common Clinical Scenarios

Patients with recurrent urogenital infections, particularly those with underlying immunocompromising conditions.

Billing Considerations

Consideration of potential drug interactions with antifungal treatments and the patient's overall health status.

Urology

Documentation Requirements

Comprehensive documentation of urinary symptoms, diagnostic tests, and treatment responses.

Common Clinical Scenarios

Patients presenting with urinary tract symptoms and a history of candidiasis.

Billing Considerations

Need to differentiate between candidiasis and other urogenital infections, such as bacterial cystitis.

Coding Guidelines

Inclusion Criteria

Use B37.49 When
  • According to ICD
  • 10 coding guidelines, B37
  • 49 should be used when the urogenital candidiasis is not specified as vulvovaginal candidiasis or other specific types
  • It is essential to document the specific site of infection and any underlying conditions that may contribute to the patient's susceptibility

Exclusion Criteria

Do NOT use B37.49 When
No specific exclusions found.

Related CPT Codes

87481CPT Code

Infectious agent detection by nucleic acid (DNA or RNA); Candida species

Clinical Scenario

Used when laboratory testing is performed to confirm the presence of Candida species.

Documentation Requirements

Documentation of the clinical indication for testing and results.

Specialty Considerations

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

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of candidiasis, improving the ability to track and manage these infections. B37.49 provides a distinct code for other urogenital candidiasis, which was less clearly defined in ICD-9.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of candidiasis, improving the ability to track and manage these infections. B37.49 provides a distinct code for other urogenital candidiasis, which was less clearly defined in ICD-9.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of candidiasis, improving the ability to track and manage these infections. B37.49 provides a distinct code for other urogenital candidiasis, which was less clearly defined in ICD-9.

Resources

Clinical References

  • •
    CDC - Fungal Diseases

Coding & Billing References

  • •
    CDC - Fungal Diseases

Frequently Asked Questions

What are the common symptoms of urogenital candidiasis?

Common symptoms include itching, burning during urination, abnormal discharge, and irritation in the genital area.

How is urogenital candidiasis diagnosed?

Diagnosis is typically made through clinical evaluation and laboratory tests, including cultures to identify the specific Candida species.

What antifungal treatments are available for urogenital candidiasis?

Common antifungal treatments include fluconazole, clotrimazole, and miconazole, depending on the severity and location of the infection.

Why is it important to document immunocompromised status in patients with candidiasis?

Immunocompromised patients are at higher risk for severe infections, and their treatment may differ significantly from immunocompetent individuals.