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ICD-10 Guide
ICD-10 CodesB42.7

B42.7

Candidiasis of vulva and vagina

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

Code Description

ICD-10 B42.7 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 referred to as a yeast infection, is a fungal infection caused primarily by the Candida species, particularly 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 healthy individuals but is more prevalent in those who are immunocompromised, such as individuals with diabetes, HIV/AIDS, or those undergoing chemotherapy. Risk factors include antibiotic use, hormonal changes (such as during pregnancy or with contraceptive use), and uncontrolled diabetes. Diagnosis is typically made through clinical evaluation and laboratory tests, including vaginal swabs. Treatment usually involves antifungal medications, which can be administered topically or orally, depending on the severity of the infection. In recurrent cases, a more comprehensive evaluation of underlying conditions may be necessary to prevent future infections.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between candidiasis and other vulvovaginal infections.
  • Identifying underlying immunocompromised conditions.
  • Documenting recurrent infections and their management.
  • Understanding the various antifungal treatments and their indications.

Audit Risk Factors

  • Inadequate documentation of symptoms and treatment.
  • Failure to document underlying conditions.
  • Misclassification of the infection type.
  • Lack of follow-up documentation for recurrent cases.

Specialty Focus

Medical Specialties

Obstetrics and Gynecology

Documentation Requirements

Detailed patient history, including symptoms, treatment response, and any underlying conditions.

Common Clinical Scenarios

Patients presenting with recurrent yeast infections, pregnant patients with candidiasis, and immunocompromised patients.

Billing Considerations

Ensure documentation reflects the severity and frequency of infections, as well as any relevant laboratory findings.

Infectious Disease

Documentation Requirements

Comprehensive documentation of the patient's immune status and any co-morbidities.

Common Clinical Scenarios

Patients with HIV/AIDS presenting with opportunistic infections, including candidiasis.

Billing Considerations

Focus on the patient's overall health status and potential for recurrent infections.

Coding Guidelines

Inclusion Criteria

Use B42.7 When
  • According to ICD
  • 10 coding guidelines, B42
  • 7 should be used when the diagnosis of candidiasis is confirmed
  • It is important to document the specific symptoms, treatment provided, and any underlying conditions that may contribute to the infection

Exclusion Criteria

Do NOT use B42.7 When
  • Exclusion criteria include other specified infections that may mimic candidiasis

Related CPT Codes

87210CPT Code

Culture, bacterial, any source

Clinical Scenario

Used when a culture is taken to confirm candidiasis.

Documentation Requirements

Document the reason for the culture and the results.

Specialty Considerations

Obstetrics and Gynecology may frequently use this code for diagnostic purposes.

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 ability to track and manage this condition. The increased specificity helps in understanding the prevalence and treatment outcomes in various populations, particularly those who are immunocompromised.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of candidiasis, improving the ability to track and manage this condition. The increased specificity helps in understanding the prevalence and treatment outcomes in various populations, particularly those who are immunocompromised.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of candidiasis, improving the ability to track and manage this condition. The increased specificity helps in understanding the prevalence and treatment outcomes in various populations, particularly those who are immunocompromised.

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. Some patients may also experience redness and swelling in the affected area.