ICD-10 Guide

B26.89

Other mumps complications

BILLABLE STATUSYes

IMPLEMENTATION DATEOctober 1, 2015

LAST UPDATED09/05/2025

Code Description

ICD-10 B26.89 is a billable code used to indicate a diagnosis of other mumps complications.

Key Diagnostic Point:

Mumps is a viral infection caused by the mumps virus, characterized by swelling of the salivary glands, particularly the parotid glands. While many cases resolve without complications, mumps can lead to various complications, particularly in adults. These complications may include orchitis (inflammation of the testicles), oophoritis (inflammation of the ovaries), meningitis, and encephalitis. Other less common complications include pancreatitis and deafness. Diagnosis of mumps and its complications typically involves clinical evaluation, serological testing for mumps-specific IgM and IgG antibodies, and PCR testing of saliva or cerebrospinal fluid in cases of suspected meningitis or encephalitis. Antiviral treatments are generally not effective against mumps; however, supportive care is crucial. This may include hydration, pain relief, and management of fever. Vaccination with the MMR (measles, mumps, rubella) vaccine is the most effective preventive measure against mumps and its complications.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

Variety of potential complications associated with mumps.
Need for accurate documentation of specific complications.
Differentiation from other viral infections with similar presentations.
Potential for overlapping codes with other viral illnesses.

Audit Risk Factors

Inadequate documentation of complications.
Misclassification of mumps complications as unrelated conditions.
Failure to link complications to the primary diagnosis.
Inconsistent use of codes for similar conditions.

Specialty Focus

Medical Specialties

Infectious Disease

Documentation Requirements

Detailed clinical notes on the patient's history, presenting symptoms, and laboratory results.

Common Clinical Scenarios

Patients presenting with parotitis, orchitis, or neurological symptoms.

Billing Considerations

Ensure that all complications are documented and linked to the mumps diagnosis.

Pediatrics

Documentation Requirements

Vaccination history, clinical presentation, and any complications observed.

Common Clinical Scenarios

Children presenting with mumps symptoms and subsequent complications.

Billing Considerations

Documentation should include vaccination status and any parental concerns.

Coding Guidelines

Inclusion Criteria

Use B26.89 When

According to ICD
10 coding guidelines, B26
89 should be used when specific complications of mumps are documented but do not fall under more specific codes
Coders must ensure that the documentation supports the use of this code and that it is not used inappropriately for unrelated conditions

Exclusion Criteria

Do NOT use B26.89 When

No specific exclusions found.

Related CPT Codes

86765CPT Code

Mumps antibody test

Clinical Scenario

Used to confirm mumps infection in patients presenting with symptoms.

Documentation Requirements

Document the reason for testing and the patient's clinical presentation.

Specialty Considerations

Infectious disease specialists may require additional lab results for comprehensive evaluation.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of mumps complications, improving the accuracy of data collection and reimbursement processes. B26.89 provides a means to capture less common complications that may have been overlooked in ICD-9.

ICD-9 vs ICD-10

Reimbursement & Billing Impact

reimbursement processes. B26.89 provides a means to capture less common complications that may have been overlooked in ICD-9.

Resources

Clinical References

•
CDC Mumps Information

Coding & Billing References

•
CDC Mumps Information

Frequently Asked Questions

What are the common complications associated with mumps?

Common complications include orchitis, oophoritis, meningitis, and encephalitis. Less common complications may include pancreatitis and deafness.

How is mumps diagnosed?

Mumps is diagnosed through clinical evaluation, serological testing for mumps-specific antibodies, and PCR testing of saliva or cerebrospinal fluid.

What is the treatment for mumps complications?

There is no specific antiviral treatment for mumps; supportive care is the mainstay of treatment, including hydration and pain management.

ICD-10 B26.89 is a billable code used to indicate a diagnosis of other mumps complications.