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ICD-10 Guide
ICD-10 CodesB27.12

B27.12

Cytomegaloviral mononucleosis with meningitis

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

Code Description

ICD-10 B27.12 is a billable code used to indicate a diagnosis of cytomegaloviral mononucleosis with meningitis.

Key Diagnostic Point:

Cytomegaloviral (CMV) mononucleosis is a viral infection caused by the cytomegalovirus, which is a member of the herpesvirus family. This condition is characterized by symptoms similar to those of infectious mononucleosis, including fever, fatigue, sore throat, and lymphadenopathy. When CMV infection leads to meningitis, it can cause inflammation of the protective membranes covering the brain and spinal cord, resulting in symptoms such as headache, neck stiffness, and altered mental status. Diagnosis typically involves serological tests to detect CMV-specific antibodies, PCR testing for viral DNA, and lumbar puncture to analyze cerebrospinal fluid (CSF) for the presence of the virus. Antiviral treatment options include ganciclovir and foscarnet, which are used primarily in immunocompromised patients, as healthy individuals often recover without specific antiviral therapy. The management of CMV mononucleosis with meningitis requires careful monitoring and supportive care, especially in patients with weakened immune systems.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between viral and bacterial meningitis
  • Need for serological and PCR testing documentation
  • Potential for co-infections with other viruses
  • Variability in clinical presentation among patients

Audit Risk Factors

  • Inadequate documentation of clinical symptoms
  • Failure to document laboratory test results
  • Misclassification of viral versus bacterial meningitis
  • Lack of specificity in coding related conditions

Specialty Focus

Medical Specialties

Infectious Disease

Documentation Requirements

Detailed history of symptoms, laboratory test results, and treatment plans.

Common Clinical Scenarios

Patients presenting with fever, fatigue, and lymphadenopathy requiring differential diagnosis.

Billing Considerations

Documentation must clearly indicate the presence of meningitis and the specific viral etiology.

Neurology

Documentation Requirements

Neurological examination findings, CSF analysis results, and imaging studies.

Common Clinical Scenarios

Patients with altered mental status and neurological symptoms requiring evaluation for viral meningitis.

Billing Considerations

Accurate documentation of neurological symptoms and their correlation with CMV infection is crucial.

Coding Guidelines

Inclusion Criteria

Use B27.12 When
  • According to ICD
  • 10 guidelines, this code should be used when there is clear documentation of cytomegaloviral infection leading to mononucleosis and meningitis
  • It is essential to ensure that the diagnosis is supported by laboratory findings and clinical symptoms

Exclusion Criteria

Do NOT use B27.12 When
No specific exclusions found.

Related CPT Codes

87491CPT Code

Cytomegalovirus (CMV) DNA, qualitative

Clinical Scenario

Used when testing for CMV in patients with suspected viral meningitis.

Documentation Requirements

Document the reason for testing and the clinical symptoms leading to the test.

Specialty Considerations

Infectious disease specialists should ensure that the clinical context supports the need for testing.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of viral infections, including CMV. This specificity aids in better tracking of disease prevalence and treatment outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of viral infections, including CMV. This specificity aids in better tracking of disease prevalence and treatment outcomes.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of viral infections, including CMV. This specificity aids in better tracking of disease prevalence and treatment outcomes.

Resources

Clinical References

  • •
    CDC - Cytomegalovirus (CMV) Infection

Coding & Billing References

  • •
    CDC - Cytomegalovirus (CMV) Infection

Frequently Asked Questions

What are the common symptoms of cytomegaloviral mononucleosis?

Common symptoms include fever, fatigue, sore throat, swollen lymph nodes, and in cases with meningitis, headache and neck stiffness.

How is cytomegaloviral meningitis diagnosed?

Diagnosis is made through clinical evaluation, serological tests for CMV antibodies, PCR testing for CMV DNA in CSF, and lumbar puncture.

What treatment options are available for CMV mononucleosis with meningitis?

Antiviral medications such as ganciclovir or foscarnet are used, especially in immunocompromised patients, along with supportive care.