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v1.0.0
ICD-10 Guide
ICD-10 CodesB26.1

B26.1

Mumps orchitis

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

Code Description

ICD-10 B26.1 is a billable code used to indicate a diagnosis of mumps orchitis.

Key Diagnostic Point:

Mumps orchitis is a viral infection characterized by inflammation of one or both testicles, typically occurring as a complication of mumps, which is caused by the mumps virus. The condition is most commonly seen in post-pubertal males, as orchitis can lead to complications such as testicular atrophy and infertility. The mumps virus is an RNA virus belonging to the Paramyxoviridae family, and it primarily spreads through respiratory droplets. Symptoms of mumps orchitis may include unilateral or bilateral testicular swelling, pain, fever, and malaise. Diagnosis is often made based on clinical presentation, patient history, and laboratory tests, including serological testing for mumps-specific IgM and IgG antibodies. Imaging studies, such as ultrasound, may be utilized to assess testicular swelling and rule out other causes of acute scrotal pain. While there is no specific antiviral treatment for mumps orchitis, supportive care, including analgesics and anti-inflammatory medications, is recommended to alleviate symptoms. Vaccination with the MMR (measles, mumps, rubella) vaccine is effective in preventing mumps and its complications, including orchitis.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between viral and bacterial orchitis
  • Need for serological confirmation of mumps infection
  • Potential for complications affecting coding
  • Variability in clinical presentation

Audit Risk Factors

  • Inadequate documentation of clinical findings
  • Failure to document vaccination status
  • Misdiagnosis of orchitis due to other causes
  • Lack of serological test results in the medical record

Specialty Focus

Medical Specialties

Urology

Documentation Requirements

Detailed clinical notes on testicular examination, imaging results, and treatment plan.

Common Clinical Scenarios

Evaluation of acute scrotal pain, management of testicular swelling, and follow-up for potential infertility.

Billing Considerations

Ensure documentation reflects the acute nature of symptoms and any complications.

Infectious Disease

Documentation Requirements

Comprehensive history of exposure, vaccination status, and laboratory test results.

Common Clinical Scenarios

Diagnosis and management of viral infections, including mumps outbreaks.

Billing Considerations

Documenting the epidemiological context of the infection is crucial.

Coding Guidelines

Inclusion Criteria

Use B26.1 When
  • According to ICD
  • 10 guidelines, B26
  • 1 should be used when mumps orchitis is confirmed through clinical and laboratory findings

Exclusion Criteria

Do NOT use B26.1 When
  • Exclusion criteria include other causes of orchitis, such as trauma or bacterial infections

Related CPT Codes

88305CPT Code

Pathology examination of testicular tissue

Clinical Scenario

When a biopsy is performed to rule out other conditions.

Documentation Requirements

Pathology report and clinical notes detailing the need for biopsy.

Specialty Considerations

Urology specialists should ensure that the indication for biopsy is clearly documented.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of mumps-related conditions, improving the accuracy of epidemiological data and treatment outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of mumps-related conditions, improving the accuracy of epidemiological data and treatment outcomes.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of mumps-related conditions, improving the accuracy of epidemiological data and treatment outcomes.

Resources

Clinical References

  • •
    CDC Mumps Information

Coding & Billing References

  • •
    CDC Mumps Information

Frequently Asked Questions

What are the common symptoms of mumps orchitis?

Common symptoms include testicular swelling, pain, fever, and malaise, typically occurring after a mumps infection.

How is mumps orchitis diagnosed?

Diagnosis is based on clinical presentation, patient history, and laboratory tests for mumps-specific antibodies.

What is the treatment for mumps orchitis?

Treatment is primarily supportive, including analgesics and anti-inflammatory medications, as there is no specific antiviral treatment.