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ICD-10 Guide
ICD-10 CodesB36

B36

Superficial mycosis

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

Code Description

ICD-10 B36 is a billable code used to indicate a diagnosis of superficial mycosis.

Key Diagnostic Point:

Superficial mycosis refers to a group of fungal infections that primarily affect the outer layers of the skin, hair, and nails. These infections are typically caused by dermatophytes, yeasts, or non-dermatophyte molds. Common examples include tinea (ringworm), candidiasis, and pityriasis versicolor. The clinical presentation may vary from mild scaling and itching to more severe inflammatory responses, depending on the pathogen and host factors. Diagnosis is often made through clinical examination and may be confirmed with laboratory tests such as KOH preparations or fungal cultures. Treatment usually involves topical antifungal agents, such as clotrimazole or terbinafine, although systemic therapy may be necessary for extensive or resistant cases. Patients who are immunocompromised, such as those with HIV/AIDS, diabetes, or undergoing chemotherapy, are at increased risk for more severe manifestations of superficial mycosis and may require more aggressive treatment and monitoring. Understanding the nuances of these infections is crucial for effective management and coding.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of causative organisms (dermatophytes, yeasts, molds)
  • Differential diagnosis with other skin conditions
  • Variability in clinical presentation
  • Need for laboratory confirmation in some cases

Audit Risk Factors

  • Inadequate documentation of the specific fungal organism
  • Failure to document immunocompromised status
  • Misclassification of the type of mycosis
  • Lack of supporting lab results for diagnosis

Specialty Focus

Medical Specialties

Dermatology

Documentation Requirements

Detailed clinical notes including lesion description, location, and treatment response.

Common Clinical Scenarios

Diagnosis and treatment of tinea corporis, tinea pedis, and onychomycosis.

Billing Considerations

Ensure accurate identification of the fungal type and any underlying conditions.

Infectious Disease

Documentation Requirements

Comprehensive patient history, including immunocompromised status and previous infections.

Common Clinical Scenarios

Management of recurrent fungal infections in immunocompromised patients.

Billing Considerations

Document any systemic treatments and their outcomes.

Coding Guidelines

Inclusion Criteria

Use B36 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the condition, including the specific type of mycosis and any relevant patient history

Exclusion Criteria

Do NOT use B36 When
  • Exclude conditions that do not fit the superficial mycosis category

Related Codes

Child Codes

6 codes
B36.0
Tinea barbae
B36.1
Tinea unguium
B36.2
Candidiasis of skin and nail
B36.3
Tinea unguium
B36.8
Other superficial mycoses
B36.9
Superficial mycosis, unspecified

Related CPT Codes

87210CPT Code

Fungal culture

Clinical Scenario

Used to confirm the diagnosis of superficial mycosis.

Documentation Requirements

Document the reason for the culture and the site from which the sample was taken.

Specialty Considerations

Dermatology may require more detailed documentation regarding the clinical findings.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of superficial mycosis, improving the accuracy of data collection and reimbursement processes. It has also facilitated better tracking of fungal infections and their outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of superficial mycosis, improving the accuracy of data collection and reimbursement processes. It has also facilitated better tracking of fungal infections and their outcomes.

Reimbursement & Billing Impact

reimbursement processes. It has also facilitated better tracking of fungal infections and their outcomes.

Resources

Clinical References

  • •
    CDC Fungal Diseases

Coding & Billing References

  • •
    CDC Fungal Diseases

Frequently Asked Questions

What is the difference between superficial mycosis and deep mycosis?

Superficial mycosis affects the outer layers of skin, hair, and nails, while deep mycosis involves deeper tissues and organs, often requiring more aggressive treatment.