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v1.0.0
ICD-10 Guide
ICD-10 CodesB51

B51

Plasmodium falciparum malaria

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

Code Description

ICD-10 B51 is a billable code used to indicate a diagnosis of plasmodium falciparum malaria.

Key Diagnostic Point:

Plasmodium falciparum malaria is a severe form of malaria caused by the Plasmodium falciparum parasite, which is transmitted to humans through the bite of infected female Anopheles mosquitoes. This species is responsible for the majority of malaria-related morbidity and mortality worldwide. Clinical manifestations can range from mild flu-like symptoms to severe complications such as cerebral malaria, acute respiratory distress syndrome, and multi-organ failure. Diagnosis is typically confirmed through blood smears or rapid diagnostic tests that detect specific antigens. Treatment involves the use of antimalarial medications, with artemisinin-based combination therapies (ACTs) being the first-line treatment. However, resistance to antimalarial drugs, particularly artemisinin, has been reported in some regions, complicating treatment protocols. Prophylaxis is recommended for travelers to endemic areas and includes medications such as atovaquone-proguanil, doxycycline, or mefloquine, depending on the region and individual patient factors. Continuous monitoring of drug resistance patterns is essential for effective management and prevention of Plasmodium falciparum malaria.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Variety of clinical presentations ranging from mild to severe
  • Need for species identification to confirm diagnosis
  • Potential for antimalarial resistance affecting treatment options
  • Prophylaxis recommendations vary by region and patient history

Audit Risk Factors

  • Inadequate documentation of travel history
  • Failure to specify the severity of the disease
  • Incorrect coding of related complications
  • Lack of evidence for prophylaxis use

Specialty Focus

Medical Specialties

Infectious Disease

Documentation Requirements

Detailed travel history, symptom onset, and laboratory confirmation of species.

Common Clinical Scenarios

Patients presenting with fever and travel history to endemic areas.

Billing Considerations

Consideration of co-morbidities and potential complications.

Travel Medicine

Documentation Requirements

Pre-travel consultation notes, prophylaxis prescriptions, and post-travel follow-up.

Common Clinical Scenarios

Travelers returning from endemic regions with febrile illness.

Billing Considerations

Emphasis on preventive measures and education on malaria risks.

Coding Guidelines

Inclusion Criteria

Use B51 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the diagnosis, including the species of malaria and any complications
  • Include relevant travel history and symptomatology

Exclusion Criteria

Do NOT use B51 When
No specific exclusions found.

Related Codes

Child Codes

3 codes
B51.0
Plasmodium falciparum malaria
B51.8
Leishmaniasis, other specified
B51.9
Plasmodium falciparum malaria, unspecified

Related CPT Codes

87430CPT Code

Malaria antigen detection

Clinical Scenario

Used when testing for malaria in symptomatic patients.

Documentation Requirements

Document the reason for testing and results.

Specialty Considerations

Infectious disease specialists should ensure accurate interpretation of test results.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of malaria types, improving data accuracy and facilitating better tracking of disease patterns and treatment outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of malaria types, improving data accuracy and facilitating better tracking of disease patterns and treatment outcomes.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of malaria types, improving data accuracy and facilitating better tracking of disease patterns and treatment outcomes.

Resources

Clinical References

  • •
    CDC Malaria Information

Coding & Billing References

  • •
    CDC Malaria Information

Frequently Asked Questions

What is the primary treatment for Plasmodium falciparum malaria?

The primary treatment is artemisinin-based combination therapy (ACT), which is effective against this species of malaria.