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v1.0.0
ICD-10 Guide
ICD-10 CodesB05.89

B05.89

Other measles complications

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

Code Description

ICD-10 B05.89 is a billable code used to indicate a diagnosis of other measles complications.

Key Diagnostic Point:

Measles is a highly contagious viral infection characterized by fever, cough, runny nose, and a distinctive rash. While many patients recover without complications, measles can lead to serious health issues, particularly in young children and immunocompromised individuals. Complications associated with measles include otitis media, pneumonia, and encephalitis. Other less common complications may arise, such as subacute sclerosing panencephalitis (SSPE), which can occur years after the initial infection. The risk of complications increases in malnourished children and those without vaccination. Vaccination against measles is crucial, as it not only protects the individual but also contributes to herd immunity, reducing the overall incidence of the disease. The use of code B05.89 is essential for capturing these other complications that do not fall under the more common categories, ensuring accurate representation of the patient's condition and appropriate resource allocation for treatment.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of potential complications that can arise from measles.
  • Need for thorough documentation to differentiate between complications.
  • Potential overlap with other viral infections and their complications.
  • Variability in clinical presentation based on patient demographics.

Audit Risk Factors

  • Inadequate documentation of complications.
  • Misclassification of complications as primary diagnoses.
  • Failure to link complications to the original measles infection.
  • Inconsistent coding practices across different healthcare providers.

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Detailed vaccination history and clinical notes on complications.

Common Clinical Scenarios

Children presenting with measles and subsequent complications like otitis media or pneumonia.

Billing Considerations

Ensure accurate coding of complications to reflect the severity of the child's condition.

Infectious Disease

Documentation Requirements

Comprehensive patient history and laboratory results confirming measles and its complications.

Common Clinical Scenarios

Adults or immunocompromised patients experiencing atypical complications from measles.

Billing Considerations

Focus on the long-term implications of measles complications, such as SSPE.

Coding Guidelines

Inclusion Criteria

Use B05.89 When
  • According to ICD
  • 10 coding guidelines, B05
  • 89 should be used when documenting complications of measles that do not fit into other specified categories
  • Coders must ensure that the primary diagnosis of measles is established before applying this code

Exclusion Criteria

Do NOT use B05.89 When
  • Exclusion criteria include cases where complications are directly attributable to other viral infections

Related CPT Codes

90460CPT Code

Immunization administration

Clinical Scenario

When a child receives the measles vaccine and requires follow-up for complications.

Documentation Requirements

Record vaccination date and any adverse reactions.

Specialty Considerations

Pediatricians should ensure accurate 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 complications, improving data accuracy and patient care tracking. B05.89 provides a means to capture less common complications that may have been overlooked in ICD-9.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of measles complications, improving data accuracy and patient care tracking. B05.89 provides a means to capture less common complications that may have been overlooked in ICD-9.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of measles complications, improving data accuracy and patient care tracking. B05.89 provides a means to capture less common complications that may have been overlooked in ICD-9.

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 otitis media, pneumonia, and encephalitis. Other complications may include SSPE, which can occur years after the initial infection.