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v1.0.0
ICD-10 Guide
ICD-10 CodesB39.2

B39.2

Pulmonary coccidioidomycosis

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

Code Description

ICD-10 B39.2 is a billable code used to indicate a diagnosis of pulmonary coccidioidomycosis.

Key Diagnostic Point:

Pulmonary coccidioidomycosis is a fungal infection caused by the inhalation of spores from the Coccidioides species, primarily C. immitis and C. posadasii. This condition is endemic to certain regions, particularly the southwestern United States, parts of Mexico, and Central and South America. The infection can range from asymptomatic to severe pulmonary disease, with symptoms including cough, fever, chest pain, and difficulty breathing. In immunocompromised patients, such as those with HIV/AIDS, cancer, or those on immunosuppressive therapy, the risk of disseminated disease increases significantly. Diagnosis is typically confirmed through serological tests, culture, or histopathological examination. Treatment often involves antifungal medications such as fluconazole or itraconazole, with amphotericin B reserved for severe cases. Early recognition and appropriate management are crucial to prevent complications, especially in vulnerable populations.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between pulmonary and disseminated forms of coccidioidomycosis.
  • Understanding the geographic prevalence and risk factors associated with the disease.
  • Recognizing the need for specific laboratory tests for accurate diagnosis.
  • Navigating treatment options based on patient immunocompetence.

Audit Risk Factors

  • Inadequate documentation of geographic exposure.
  • Failure to specify the immunocompromised status of the patient.
  • Misclassification of the severity of the infection.
  • Lack of supporting lab results in the medical record.

Specialty Focus

Medical Specialties

Infectious Disease

Documentation Requirements

Detailed patient history, exposure history, lab results, and treatment plans.

Common Clinical Scenarios

Patients presenting with respiratory symptoms after travel to endemic areas.

Billing Considerations

Ensure documentation reflects the severity and treatment response.

Pulmonology

Documentation Requirements

Pulmonary function tests, imaging studies, and treatment response documentation.

Common Clinical Scenarios

Patients with chronic cough and respiratory distress.

Billing Considerations

Document any co-morbid respiratory conditions.

Coding Guidelines

Inclusion Criteria

Use B39.2 When
  • Follow the official ICD
  • CM coding guidelines for fungal infections, ensuring accurate documentation of the patient's clinical status and any relevant comorbidities
  • Include specific details about the patient's immune status and treatment response

Exclusion Criteria

Do NOT use B39.2 When
No specific exclusions found.

Related CPT Codes

87481CPT Code

Coccidioides antibody test

Clinical Scenario

Used to confirm diagnosis in suspected cases.

Documentation Requirements

Document the reason for testing and results.

Specialty Considerations

Infectious disease specialists should ensure comprehensive lab documentation.

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, improving the accuracy of data collection and reimbursement processes. B39.2 provides a clear distinction for pulmonary coccidioidomycosis, enhancing clinical understanding and treatment pathways.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of fungal infections, improving the accuracy of data collection and reimbursement processes. B39.2 provides a clear distinction for pulmonary coccidioidomycosis, enhancing clinical understanding and treatment pathways.

Reimbursement & Billing Impact

reimbursement processes. B39.2 provides a clear distinction for pulmonary coccidioidomycosis, enhancing clinical understanding and treatment pathways.

Resources

Clinical References

  • •
    CDC Coccidioidomycosis Information

Coding & Billing References

  • •
    CDC Coccidioidomycosis Information

Frequently Asked Questions

What are the common symptoms of pulmonary coccidioidomycosis?

Common symptoms include cough, fever, chest pain, and difficulty breathing. Some patients may be asymptomatic.

How is pulmonary coccidioidomycosis diagnosed?

Diagnosis is typically made through serological tests, culture, or imaging studies that reveal pulmonary involvement.

What antifungal treatments are used for pulmonary coccidioidomycosis?

Common antifungal treatments include fluconazole, itraconazole, and amphotericin B for severe cases.

Why is it important to document immunocompromised status?

Immunocompromised patients are at higher risk for severe disease and may require different treatment protocols.