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v1.0.0
ICD-10 Guide
ICD-10 CodesB42.9

B42.9

Chronic disseminated candidiasis, unspecified

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

Code Description

ICD-10 B42.9 is a billable code used to indicate a diagnosis of chronic disseminated candidiasis, unspecified.

Key Diagnostic Point:

Chronic disseminated candidiasis is a systemic fungal infection caused by Candida species, primarily affecting immunocompromised individuals. This condition is characterized by the widespread presence of Candida in the bloodstream and various organs, leading to severe morbidity. Patients may present with nonspecific symptoms such as fever, chills, and malaise, which can progress to more severe manifestations like septic shock or multi-organ failure if not promptly treated. The diagnosis is often confirmed through blood cultures, imaging studies, and clinical evaluation. Chronic disseminated candidiasis is particularly prevalent in patients with weakened immune systems, such as those undergoing chemotherapy, organ transplantation, or those with HIV/AIDS. Treatment typically involves antifungal agents, with echinocandins, azoles, and polyenes being the mainstays of therapy. The choice of antifungal depends on the severity of the infection, the patient's overall health, and potential drug interactions. Monitoring for treatment response and potential side effects is crucial in managing this condition effectively.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of clinical presentations in immunocompromised patients
  • Need for accurate identification of Candida species
  • Differentiation from other fungal infections
  • Potential for co-infections complicating the diagnosis

Audit Risk Factors

  • Inadequate documentation of immunocompromised status
  • Failure to specify the type of Candida infection
  • Lack of supporting lab results for diagnosis
  • Inconsistent treatment documentation

Specialty Focus

Medical Specialties

Infectious Disease

Documentation Requirements

Detailed clinical notes on patient history, lab results, and treatment plans.

Common Clinical Scenarios

Patients with HIV/AIDS presenting with systemic fungal infections.

Billing Considerations

Ensure documentation reflects the chronic nature and any complications arising from the infection.

Hematology/Oncology

Documentation Requirements

Comprehensive records of chemotherapy regimens and patient responses.

Common Clinical Scenarios

Cancer patients developing candidiasis during or after chemotherapy.

Billing Considerations

Document the patient's immunocompromised state and any concurrent infections.

Coding Guidelines

Inclusion Criteria

Use B42.9 When
  • According to ICD
  • 10 guidelines, B42
  • 9 should be used when the specific type of candidiasis is not documented
  • It is essential to ensure that the condition is chronic and disseminated, as acute or localized infections would require different codes

Exclusion Criteria

Do NOT use B42.9 When
No specific exclusions found.

Related CPT Codes

87481CPT Code

Candidiasis testing

Clinical Scenario

Used when testing for Candida species in patients suspected of having disseminated candidiasis.

Documentation Requirements

Document the reason for testing and any relevant clinical findings.

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 chronic disseminated candidiasis, improving the accuracy of data collection and reimbursement processes. This specificity aids in better tracking of fungal infections in immunocompromised populations.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of chronic disseminated candidiasis, improving the accuracy of data collection and reimbursement processes. This specificity aids in better tracking of fungal infections in immunocompromised populations.

Reimbursement & Billing Impact

reimbursement processes. This specificity aids in better tracking of fungal infections in immunocompromised populations.

Resources

Clinical References

  • •
    CDC - Fungal Diseases

Coding & Billing References

  • •
    CDC - Fungal Diseases

Frequently Asked Questions

What is the primary treatment for chronic disseminated candidiasis?

The primary treatment involves systemic antifungal therapy, typically with echinocandins, azoles, or polyenes, depending on the patient's clinical status and any potential drug interactions.