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v1.0.0
ICD-10 Guide
ICD-10 CodesB37.7

B37.7

Candidal sepsis

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

Code Description

ICD-10 B37.7 is a billable code used to indicate a diagnosis of candidal sepsis.

Key Diagnostic Point:

Candidal sepsis is a severe systemic infection caused by Candida species, primarily Candida albicans, which can lead to significant morbidity and mortality, particularly in immunocompromised patients. This condition arises when Candida enters the bloodstream, often following invasive procedures, prolonged antibiotic use, or in the presence of central venous catheters. Patients at higher risk include those with weakened immune systems due to conditions such as HIV/AIDS, cancer, diabetes, or those undergoing immunosuppressive therapy. Symptoms may include fever, chills, tachycardia, and hypotension, which can progress to septic shock if not promptly treated. Diagnosis typically involves blood cultures, and treatment usually consists of antifungal agents such as fluconazole or echinocandins. Early recognition and intervention are critical to improving outcomes in affected patients.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Differentiating between candidemia and candidal sepsis
  • Identifying underlying immunocompromised conditions
  • Understanding the nuances of antifungal therapy
  • Documenting the severity and systemic nature of the infection

Audit Risk Factors

  • Inadequate documentation of immunocompromised status
  • Failure to specify the causative organism
  • Misclassification of sepsis severity
  • Lack of clear treatment documentation

Specialty Focus

Medical Specialties

Infectious Disease

Documentation Requirements

Detailed clinical notes on the patient's immunocompromised status, laboratory results, and treatment plans.

Common Clinical Scenarios

Patients presenting with fever and chills after chemotherapy or prolonged antibiotic therapy.

Billing Considerations

Ensure that the documentation reflects the systemic nature of the infection and any underlying conditions.

Critical Care

Documentation Requirements

Comprehensive notes on vital signs, treatment interventions, and response to therapy.

Common Clinical Scenarios

Patients in the ICU with septic shock attributed to candidal sepsis.

Billing Considerations

Accurate documentation of sepsis criteria and treatment protocols is essential for coding.

Coding Guidelines

Inclusion Criteria

Use B37.7 When
  • According to ICD
  • 10 coding guidelines, B37
  • 7 should be used when there is clear evidence of systemic infection due to Candida species
  • It is important to document the patient's immunocompromised status and any relevant clinical findings

Exclusion Criteria

Do NOT use B37.7 When
  • Exclusion criteria include localized candidiasis without systemic involvement

Related CPT Codes

87591CPT Code

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

Clinical Scenario

Used when confirming the presence of Candida in blood samples.

Documentation Requirements

Document the reason for testing and results.

Specialty Considerations

Infectious disease specialists should ensure accurate coding based on test results.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of candidal infections, improving the accuracy of data collection and reimbursement processes. B37.7 provides a clear distinction for candidal sepsis, which was less defined in ICD-9.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of candidal infections, improving the accuracy of data collection and reimbursement processes. B37.7 provides a clear distinction for candidal sepsis, which was less defined in ICD-9.

Reimbursement & Billing Impact

reimbursement processes. B37.7 provides a clear distinction for candidal sepsis, which was less defined in ICD-9.

Resources

Clinical References

  • •
    CDC Guidelines for the Prevention of Candidiasis

Coding & Billing References

  • •
    CDC Guidelines for the Prevention of Candidiasis

Frequently Asked Questions

What is the primary treatment for candidal sepsis?

The primary treatment for candidal sepsis includes antifungal medications such as fluconazole or echinocandins, depending on the severity of the infection and the patient's clinical status.