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v1.0.0
ICD-10 Guide
ICD-10 CodesB39

B39

Histoplasmosis

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

Code Description

ICD-10 B39 is a billable code used to indicate a diagnosis of histoplasmosis.

Key Diagnostic Point:

Histoplasmosis is a systemic fungal infection caused by the dimorphic fungus Histoplasma capsulatum. This organism is primarily found in soil enriched with bird or bat droppings, particularly in certain geographic areas such as the Ohio and Mississippi River valleys. The infection can manifest in various forms, ranging from asymptomatic pulmonary involvement to severe disseminated disease, especially in immunocompromised individuals. In healthy individuals, histoplasmosis often presents as a self-limiting respiratory illness, characterized by flu-like symptoms, cough, fever, and chest pain. However, in patients with weakened immune systems, such as those with HIV/AIDS, organ transplant recipients, or those on immunosuppressive therapy, the disease can progress to a more severe form, affecting multiple organ systems and leading to significant morbidity and mortality. Diagnosis is typically confirmed through serological tests, culture, or histopathological examination of tissue samples. Treatment usually involves antifungal medications, with itraconazole being the first-line therapy for mild to moderate cases, while severe cases may require amphotericin B. Early recognition and appropriate management are crucial to improving outcomes in affected patients.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation among immunocompromised patients
  • Need for accurate documentation of symptoms and diagnostic tests
  • Differentiation from other fungal infections
  • Potential for co-infection with other pathogens

Audit Risk Factors

  • Inadequate documentation of immunocompromised status
  • Failure to specify the form of histoplasmosis (acute vs. chronic)
  • Misclassification of histoplasmosis as a non-fungal infection
  • Lack of supporting laboratory results in the medical record

Specialty Focus

Medical Specialties

Infectious Disease

Documentation Requirements

Detailed clinical history, laboratory results, and treatment plans must be documented.

Common Clinical Scenarios

Patients presenting with respiratory symptoms, fever, and a history of exposure to endemic areas.

Billing Considerations

Documentation should clearly indicate the patient's immune status and any co-morbid conditions.

Pulmonology

Documentation Requirements

Pulmonary function tests, imaging studies, and response to treatment should be documented.

Common Clinical Scenarios

Patients with chronic cough, hemoptysis, or pneumonia-like symptoms.

Billing Considerations

Ensure that the relationship between histoplasmosis and respiratory symptoms is clearly articulated.

Coding Guidelines

Inclusion Criteria

Use B39 When
  • According to ICD
  • 10 guidelines, B39 should be used when histoplasmosis is confirmed through appropriate diagnostic testing
  • It is essential to document the patient's immune status and any related conditions that may affect treatment and prognosis

Exclusion Criteria

Do NOT use B39 When
No specific exclusions found.

Related Codes

Child Codes

7 codes
B39.0
Pulmonary coccidioidomycosis
B39.1
Pulmonary coccidioidomycosis
B39.2
Pulmonary coccidioidomycosis
B39.3
Histoplasmosis capsulati, unspecified
B39.4
Histoplasmosis capsulati, unspecified
B39.5
Pulmonary coccidioidomycosis
B39.9
Histoplasmosis, unspecified

Related CPT Codes

87449CPT Code

Infectious agent detection by nucleic acid (DNA or RNA); fungal, direct probe technique

Clinical Scenario

Used when confirming the presence of Histoplasma capsulatum in a patient with suspected histoplasmosis.

Documentation Requirements

Document the reason for testing and any relevant clinical findings.

Specialty Considerations

Infectious disease specialists should ensure that all relevant clinical data is included.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of histoplasmosis, enabling better tracking of the disease and its complications. This specificity aids in research and improves patient care by allowing for targeted treatment protocols.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of histoplasmosis, enabling better tracking of the disease and its complications. This specificity aids in research and improves patient care by allowing for targeted treatment protocols.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of histoplasmosis, enabling better tracking of the disease and its complications. This specificity aids in research and improves patient care by allowing for targeted treatment protocols.

Resources

Clinical References

  • •
    CDC - Histoplasmosis

Coding & Billing References

  • •
    CDC - Histoplasmosis

Frequently Asked Questions

What are the common symptoms of histoplasmosis?

Common symptoms include fever, cough, chest pain, fatigue, and weight loss. In severe cases, it can lead to respiratory distress and systemic symptoms.

How is histoplasmosis diagnosed?

Diagnosis is typically made through a combination of clinical evaluation, serological tests, culture of the organism, and imaging studies.

What is the treatment for histoplasmosis?

Treatment usually involves antifungal medications such as itraconazole for mild to moderate cases, while severe cases may require amphotericin B.

Who is at risk for severe histoplasmosis?

Individuals who are immunocompromised, such as those with HIV/AIDS, organ transplant recipients, or those on immunosuppressive therapy, are at higher risk for severe disease.