ICD-10 Guide

B37.9

Candidiasis, unspecified

BILLABLE STATUSYes

IMPLEMENTATION DATEOctober 1, 2015

LAST UPDATED09/05/2025

Code Description

ICD-10 B37.9 is a billable code used to indicate a diagnosis of candidiasis, unspecified.

Key Diagnostic Point:

Candidiasis, commonly known as a yeast infection, is caused by the overgrowth of Candida species, particularly Candida albicans. This fungal infection can affect various parts of the body, including the mouth (oral thrush), skin, and genital areas. In immunocompromised patients, such as those with HIV/AIDS, cancer, or those undergoing immunosuppressive therapy, candidiasis can become systemic and lead to severe complications. Symptoms may include itching, redness, and discomfort in affected areas, as well as systemic symptoms like fever and chills in more severe cases. Diagnosis is typically made through clinical evaluation and laboratory tests, including cultures or swabs of the affected area. Treatment usually involves antifungal medications, such as fluconazole or topical agents, depending on the severity and location of the infection. It is crucial to address underlying conditions that may predispose patients to candidiasis, particularly in immunocompromised individuals, to prevent recurrence and complications.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

Variety of clinical presentations (oral, vaginal, systemic)
Differentiation from other fungal infections
Need for accurate documentation of immunocompromised status
Potential for co-infections with other pathogens

Audit Risk Factors

Inadequate documentation of symptoms and clinical findings
Failure to specify the site of infection
Lack of information on immunocompromised status
Inconsistent coding of related conditions

Specialty Focus

Medical Specialties

Infectious Disease

Documentation Requirements

Detailed clinical history, including immunocompromised status and treatment response.

Common Clinical Scenarios

Patients presenting with recurrent infections or systemic candidiasis.

Billing Considerations

Consideration of antifungal resistance and alternative treatments.

Dermatology

Documentation Requirements

Clear description of skin lesions and associated symptoms.

Common Clinical Scenarios

Patients with skin candidiasis presenting with rashes or lesions.

Billing Considerations

Differentiation from other dermatological conditions.

Coding Guidelines

Inclusion Criteria

Use B37.9 When

Follow official ICD
10 coding guidelines, ensuring accurate documentation of the site of infection and patient history

Exclusion Criteria

Do NOT use B37.9 When

Exclude conditions that are not classified under candidiasis

Related CPT Codes

87591CPT Code

Candidiasis culture

Clinical Scenario

When a culture is performed to confirm candidiasis diagnosis.

Documentation Requirements

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

Specialty Considerations

Infectious disease specialists may require additional lab results.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of candidiasis, improving the ability to track and manage this condition across different patient populations.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of candidiasis, improving the ability to track and manage this condition across different patient populations.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of candidiasis, improving the ability to track and manage this condition across different patient populations.

Resources

Clinical References

•
CDC Candidiasis Overview

Coding & Billing References

•
CDC Candidiasis Overview

Frequently Asked Questions

What are the common symptoms of candidiasis?

Common symptoms include itching, redness, and discomfort in affected areas, as well as systemic symptoms like fever and chills in severe cases.

How is candidiasis diagnosed?

Diagnosis is typically made through clinical evaluation and laboratory tests, including cultures or swabs of the affected area.

What treatments are available for candidiasis?

Treatment usually involves antifungal medications, such as fluconazole or topical agents, depending on the severity and location of the infection.

ICD-10 B37.9 is a billable code used to indicate a diagnosis of candidiasis, unspecified.