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ICD-10 Guide
ICD-10 CodesB56.1

B56.1

Toxoplasma chorioretinitis

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

Code Description

ICD-10 B56.1 is a billable code used to indicate a diagnosis of toxoplasma chorioretinitis.

Key Diagnostic Point:

Toxoplasma chorioretinitis is an ocular manifestation of Toxoplasma gondii infection, a protozoan parasite that can cause significant morbidity, particularly in immunocompromised individuals and during pregnancy. The condition is characterized by inflammation of the choroid and retina, leading to symptoms such as blurred vision, floaters, and in severe cases, vision loss. The infection is often acquired through ingestion of oocysts found in contaminated food or water, or through contact with infected cat feces. In immunocompetent individuals, Toxoplasma chorioretinitis may remain asymptomatic or present with mild symptoms, but in those with weakened immune systems, such as patients with HIV/AIDS or those undergoing chemotherapy, the disease can be more severe. Diagnosis typically involves clinical examination, serological testing for Toxoplasma antibodies, and imaging studies such as fundus photography or optical coherence tomography. Treatment usually includes antiparasitic medications like pyrimethamine and sulfadiazine, often combined with corticosteroids to reduce inflammation. Early diagnosis and treatment are crucial to prevent complications and preserve vision.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiation from other forms of chorioretinitis
  • Need for comprehensive patient history including immunocompromised status
  • Potential for co-infection with other pathogens
  • Variability in clinical presentation

Audit Risk Factors

  • Inadequate documentation of symptoms and clinical findings
  • Failure to document the patient's immunocompromised status
  • Misclassification of the type of chorioretinitis
  • Lack of supporting laboratory test results

Specialty Focus

Medical Specialties

Ophthalmology

Documentation Requirements

Detailed ocular examination findings, including visual acuity and fundoscopic findings.

Common Clinical Scenarios

Patients presenting with vision changes, floaters, or eye pain.

Billing Considerations

Documentation must clearly indicate the relationship between Toxoplasma infection and ocular symptoms.

Infectious Disease

Documentation Requirements

Comprehensive history of exposure, serological test results, and treatment plans.

Common Clinical Scenarios

Immunocompromised patients with systemic symptoms and ocular involvement.

Billing Considerations

Need to document the patient's immune status and any concurrent infections.

Coding Guidelines

Inclusion Criteria

Use B56.1 When
  • According to ICD
  • 10 guidelines, B56
  • 1 should be used when the diagnosis of Toxoplasma chorioretinitis is confirmed through clinical evaluation and laboratory testing
  • It is important to document the patient's immune status and any related conditions

Exclusion Criteria

Do NOT use B56.1 When
No specific exclusions found.

Related CPT Codes

92002CPT Code

Ophthalmological examination, new patient

Clinical Scenario

Used when a new patient presents with symptoms suggestive of Toxoplasma chorioretinitis.

Documentation Requirements

Complete ocular examination findings and patient history.

Specialty Considerations

Ophthalmologists should document specific findings related to Toxoplasma infection.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of Toxoplasma infections, improving the accuracy of data collection and reimbursement processes. B56.1 provides a clear distinction for chorioretinitis, enhancing clinical understanding and treatment planning.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of Toxoplasma infections, improving the accuracy of data collection and reimbursement processes. B56.1 provides a clear distinction for chorioretinitis, enhancing clinical understanding and treatment planning.

Reimbursement & Billing Impact

reimbursement processes. B56.1 provides a clear distinction for chorioretinitis, enhancing clinical understanding and treatment planning.

Resources

Clinical References

  • •
    CDC Toxoplasmosis Information

Coding & Billing References

  • •
    CDC Toxoplasmosis Information

Frequently Asked Questions

What are the common symptoms of Toxoplasma chorioretinitis?

Common symptoms include blurred vision, floaters, eye pain, and in severe cases, vision loss. Patients may also experience systemic symptoms if the infection is widespread.