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v1.0.0
ICD-10 Guide
ICD-10 CodesB40.7

B40.7

Candidal sepsis

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

Code Description

ICD-10 B40.7 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, a type of yeast that can lead to significant morbidity and mortality, particularly in immunocompromised patients. This condition arises when Candida enters the bloodstream, often following a breach in mucosal barriers or through invasive medical procedures. Patients at high risk include those with weakened immune systems due to conditions such as HIV/AIDS, cancer, diabetes, or those undergoing immunosuppressive therapies. Clinical manifestations may include fever, chills, hypotension, and multi-organ dysfunction, necessitating prompt recognition and treatment. Diagnosis typically involves blood cultures, which may take time to yield results, complicating timely management. Antifungal therapy, primarily with agents such as fluconazole, caspofungin, or amphotericin B, is critical for treatment. The choice of antifungal depends on the severity of the infection, the patient's clinical status, and local resistance patterns. Early intervention is crucial to improve outcomes, as delays in treatment can lead to increased mortality rates.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Differentiating between various types of sepsis and fungal infections.
  • Understanding the immunocompromised status of the patient.
  • Navigating the nuances of antifungal therapy and resistance.
  • Accurate documentation of clinical manifestations and laboratory findings.

Audit Risk Factors

  • Inadequate documentation of the patient's immunocompromised status.
  • Failure to document the specific Candida species involved.
  • Lack of clarity in the clinical presentation and laboratory results.
  • Misclassification of the infection type (bacterial vs. fungal).

Specialty Focus

Medical Specialties

Infectious Disease

Documentation Requirements

Detailed clinical notes on the patient's history, risk factors, and response to treatment.

Common Clinical Scenarios

Patients with recurrent infections, those undergoing chemotherapy, or with chronic illnesses.

Billing Considerations

Ensure that all antifungal treatments and their indications are clearly documented.

Critical Care

Documentation Requirements

Comprehensive records of vital signs, organ function, and treatment protocols.

Common Clinical Scenarios

Management of septic shock and multi-organ failure in critically ill patients.

Billing Considerations

Document the timeline of sepsis progression and interventions taken.

Coding Guidelines

Inclusion Criteria

Use B40.7 When
  • According to ICD
  • 10 guidelines, B40
  • 7 should be used when there is clear documentation of candidal sepsis, supported by laboratory findings
  • It is essential to document the patient's immunocompromised status and any relevant clinical details that support the diagnosis

Exclusion Criteria

Do NOT use B40.7 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 rapid identification of Candida is needed in a septic patient.

Documentation Requirements

Document the reason for testing and the clinical context.

Specialty Considerations

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

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. B40.7 provides a clear distinction from other types of sepsis, facilitating better patient management and research.

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. B40.7 provides a clear distinction from other types of sepsis, facilitating better patient management and research.

Reimbursement & Billing Impact

reimbursement processes. B40.7 provides a clear distinction from other types of sepsis, facilitating better patient management and research.

Resources

Clinical References

  • •
    CDC Guidelines on Fungal Infections

Coding & Billing References

  • •
    CDC Guidelines on Fungal Infections

Frequently Asked Questions

What is the primary treatment for candidal sepsis?

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