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v1.0.0
ICD-10 Guide
ICD-10 CodesB05.8

B05.8

Measles with other complications

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

Code Description

ICD-10 B05.8 is a billable code used to indicate a diagnosis of measles with other complications.

Key Diagnostic Point:

Measles, also known as rubeola, is a highly contagious viral infection characterized by a prodromal phase of fever, cough, coryza, and conjunctivitis, followed by a characteristic maculopapular rash. Complications from measles can arise, particularly in malnourished children or those with weakened immune systems. Common complications include diarrhea, otitis media, and pneumonia, which can lead to severe morbidity and mortality. Encephalitis, although rare, can occur in approximately 1 in 1,000 cases and may result in permanent neurological damage. The presence of these complications necessitates the use of the B05.8 code, which captures cases of measles with additional complications beyond the typical presentation. Vaccination is crucial in preventing measles; the MMR (measles, mumps, rubella) vaccine is effective in providing immunity. Despite the availability of vaccines, outbreaks can occur, particularly in populations with low vaccination rates, highlighting the importance of maintaining high immunization coverage to prevent complications associated with measles.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between measles and other viral exanthems.
  • Identifying and documenting specific complications.
  • Understanding vaccination history and its impact on disease severity.
  • Navigating the nuances of coding for complications versus primary diagnosis.

Audit Risk Factors

  • Inadequate documentation of complications.
  • Failure to link complications to the primary diagnosis.
  • Misclassification of measles severity.
  • Inconsistent vaccination history documentation.

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Detailed clinical notes on symptoms, vaccination status, and any complications observed.

Common Clinical Scenarios

Children presenting with fever and rash, particularly in unvaccinated populations.

Billing Considerations

Ensure accurate documentation of complications such as pneumonia or encephalitis.

Infectious Disease

Documentation Requirements

Comprehensive history of exposure, vaccination status, and detailed clinical findings.

Common Clinical Scenarios

Patients with severe measles complications requiring hospitalization.

Billing Considerations

Focus on the management of complications and their impact on treatment plans.

Coding Guidelines

Inclusion Criteria

Use B05.8 When
  • According to ICD
  • 10 guidelines, B05
  • 8 should be used when a patient has measles accompanied by other complications
  • It is essential to document the specific complications to justify the use of this code

Exclusion Criteria

Do NOT use B05.8 When
No specific exclusions found.

Related CPT Codes

90460CPT Code

Immunization administration

Clinical Scenario

When administering the MMR vaccine to prevent measles.

Documentation Requirements

Document vaccine type, date administered, and patient consent.

Specialty Considerations

Pediatricians should ensure proper documentation of vaccination history.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of measles and its complications, improving the accuracy of data collection and reimbursement processes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of measles and its complications, improving the accuracy of data collection and reimbursement processes.

Reimbursement & Billing Impact

reimbursement processes.

Resources

Clinical References

  • •
    CDC Measles Information

Coding & Billing References

  • •
    CDC Measles Information

Frequently Asked Questions

What are the common complications associated with measles?

Common complications include pneumonia, otitis media, diarrhea, and encephalitis. These complications can lead to severe health issues, particularly in unvaccinated individuals.