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ICD-10 Guide
ICD-10 CodesB38.7

B38.7

Candidiasis of vulva and vagina

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

Code Description

ICD-10 B38.7 is a billable code used to indicate a diagnosis of candidiasis of vulva and vagina.

Key Diagnostic Point:

Candidiasis of the vulva and vagina, commonly known as a yeast infection, is a fungal infection caused primarily by the yeast species Candida albicans. This condition is characterized by symptoms such as itching, burning, and abnormal vaginal discharge, which may appear thick and white, resembling cottage cheese. The infection can occur in women of all ages but is more prevalent in those who are pregnant, have diabetes, or are taking antibiotics. The vulva may also exhibit redness and swelling. Diagnosis is typically made through clinical evaluation and may be confirmed with laboratory tests, including a wet mount or culture. Treatment usually involves antifungal medications, which can be administered topically or orally. In immunocompromised patients, such as those with HIV/AIDS or undergoing chemotherapy, candidiasis can be more severe and recurrent, necessitating a more aggressive treatment approach and careful monitoring. Understanding the underlying risk factors and appropriate management strategies is crucial for effective treatment and prevention of recurrence.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between candidiasis and other vulvovaginal infections.
  • Identifying underlying conditions that may predispose patients to recurrent infections.
  • Documenting the severity and duration of symptoms accurately.
  • Understanding the implications of antifungal resistance in treatment.

Audit Risk Factors

  • Inadequate documentation of symptoms leading to misdiagnosis.
  • Failure to document underlying conditions that may affect treatment.
  • Incorrect coding of recurrent infections without proper justification.
  • Lack of clarity in distinguishing between candidiasis and other infections.

Specialty Focus

Medical Specialties

Gynecology

Documentation Requirements

Detailed patient history, including symptom duration and previous treatments.

Common Clinical Scenarios

Patients presenting with recurrent yeast infections or those with atypical symptoms.

Billing Considerations

Consideration of hormonal factors and other gynecological conditions that may mimic candidiasis.

Infectious Disease

Documentation Requirements

Comprehensive assessment of immunocompromised status and potential for systemic infection.

Common Clinical Scenarios

Patients with HIV/AIDS or those undergoing immunosuppressive therapy presenting with severe candidiasis.

Billing Considerations

Need for close monitoring and potential for systemic antifungal therapy.

Coding Guidelines

Inclusion Criteria

Use B38.7 When
  • According to ICD
  • 10 guidelines, B38
  • 7 should be used when the diagnosis of candidiasis is confirmed
  • It is important to document the specific site of infection and any relevant patient history, including immunocompromised status

Exclusion Criteria

Do NOT use B38.7 When
  • Exclusion criteria include other specified infections that may mimic candidiasis

Related CPT Codes

87210CPT Code

Culture, fungal, any source

Clinical Scenario

Used when a culture is taken to confirm candidiasis.

Documentation Requirements

Document the site of culture and reason for testing.

Specialty Considerations

Gynecologists may frequently order this test for suspected cases.

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 accuracy of data collection and treatment tracking. This specificity aids in better understanding the epidemiology of the condition and enhances patient care.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of candidiasis, improving the accuracy of data collection and treatment tracking. This specificity aids in better understanding the epidemiology of the condition and enhances patient care.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of candidiasis, improving the accuracy of data collection and treatment tracking. This specificity aids in better understanding the epidemiology of the condition and enhances patient care.

Resources

Clinical References

  • •
    CDC - Candidiasis

Coding & Billing References

  • •
    CDC - Candidiasis

Frequently Asked Questions

What are the common symptoms of candidiasis of the vulva and vagina?

Common symptoms include itching, burning, and a thick, white discharge that resembles cottage cheese. There may also be redness and swelling of the vulva.