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v1.0.0
ICD-10 Guide
ICD-10 CodesB40.0

B40.0

Candidal meningitis

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

Code Description

ICD-10 B40.0 is a billable code used to indicate a diagnosis of candidal meningitis.

Key Diagnostic Point:

Candidal meningitis is a rare but serious fungal infection of the central nervous system caused by Candida species, most commonly Candida albicans. This condition typically occurs in immunocompromised patients, such as those with HIV/AIDS, cancer, or those undergoing immunosuppressive therapy. The infection can manifest as a result of hematogenous spread from other sites of infection, such as the bloodstream or from direct extension from adjacent structures. Symptoms may include fever, headache, neck stiffness, altered mental status, and other neurological deficits. Diagnosis is often confirmed through lumbar puncture, where cerebrospinal fluid (CSF) analysis reveals the presence of Candida organisms. Treatment typically involves antifungal therapy, with agents such as amphotericin B or fluconazole being the most commonly used. Early diagnosis and prompt treatment are crucial to improving outcomes, as candidal meningitis can lead to significant morbidity and mortality if left untreated.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Requires understanding of fungal infections and their implications in immunocompromised patients.
  • Differentiation from other types of meningitis (bacterial, viral) is necessary.
  • Documentation must clearly indicate the immunocompromised status of the patient.
  • Potential for misclassification with other candidiasis codes.

Audit Risk Factors

  • Inadequate documentation of immunocompromised status.
  • Failure to document the specific Candida species involved.
  • Misdiagnosis or lack of clarity in differentiating from other meningitis types.
  • Inconsistent coding of associated conditions.

Specialty Focus

Medical Specialties

Infectious Disease

Documentation Requirements

Detailed history of immunocompromised conditions, laboratory results, and treatment plans.

Common Clinical Scenarios

Patients with HIV/AIDS presenting with neurological symptoms, patients with recent chemotherapy.

Billing Considerations

Ensure clear documentation of the source of infection and any prior antifungal treatments.

Neurology

Documentation Requirements

Neurological examination findings, imaging results, and CSF analysis.

Common Clinical Scenarios

Patients presenting with altered mental status and signs of meningitis.

Billing Considerations

Document any differential diagnoses considered and the rationale for the final diagnosis.

Coding Guidelines

Inclusion Criteria

Use B40.0 When
  • Follow the official ICD
  • CM coding guidelines for infectious diseases, ensuring that the code is used only when there is clear documentation of candidal meningitis

Exclusion Criteria

Do NOT use B40.0 When
  • Exclude other types of meningitis unless specified

Related CPT Codes

62270CPT Code

Lumbar puncture

Clinical Scenario

Used to obtain CSF for analysis in suspected meningitis cases.

Documentation Requirements

Document indication for procedure, patient consent, and CSF findings.

Specialty Considerations

Neurology specialists should ensure thorough documentation of neurological assessments.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of candidal infections, improving the accuracy of data collection and reimbursement processes. It emphasizes the need for detailed documentation of the patient's immunocompromised status and the specific type of candidiasis.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of candidal infections, improving the accuracy of data collection and reimbursement processes. It emphasizes the need for detailed documentation of the patient's immunocompromised status and the specific type of candidiasis.

Reimbursement & Billing Impact

reimbursement processes. It emphasizes the need for detailed documentation of the patient's immunocompromised status and the specific type of candidiasis.

Resources

Clinical References

  • •
    CDC Guidelines on Fungal Infections

Coding & Billing References

  • •
    CDC Guidelines on Fungal Infections

Frequently Asked Questions

What are the common symptoms of candidal meningitis?

Common symptoms include fever, headache, neck stiffness, altered mental status, and neurological deficits. Prompt recognition and treatment are essential.