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ICD-10 Guide
ICD-10 CodesB41.9

B41.9

Paracoccidioidomycosis, unspecified

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

Code Description

ICD-10 B41.9 is a billable code used to indicate a diagnosis of paracoccidioidomycosis, unspecified.

Key Diagnostic Point:

Paracoccidioidomycosis is a systemic fungal infection caused by the dimorphic fungus Paracoccidioides brasiliensis, primarily endemic to regions of Central and South America. The infection typically manifests in two forms: acute and chronic, with the chronic form being more prevalent. Patients may present with respiratory symptoms, skin lesions, and systemic manifestations such as fever and weight loss. The disease is particularly concerning in immunocompromised individuals, who may experience more severe symptoms and complications. Diagnosis is often made through clinical evaluation, serological tests, and histopathological examination of tissue samples. Treatment usually involves antifungal therapy, with itraconazole and sulfamethoxazole-trimethoprim being common choices. The unspecified designation indicates that the specific form or severity of the infection has not been documented, which may complicate treatment decisions and coding accuracy.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and severity of the disease.
  • Need for specific documentation regarding the form of paracoccidioidomycosis.
  • Potential overlap with other fungal infections, complicating differential diagnosis.
  • Variations in treatment protocols based on patient immunocompetence.

Audit Risk Factors

  • Inadequate documentation of clinical findings.
  • Failure to specify the form of paracoccidioidomycosis.
  • Misuse of unspecified codes leading to potential denials.
  • Inconsistent treatment documentation.

Specialty Focus

Medical Specialties

Infectious Disease

Documentation Requirements

Detailed clinical history, laboratory results, and treatment plans.

Common Clinical Scenarios

Patients presenting with respiratory symptoms and systemic signs of infection.

Billing Considerations

Documentation should clearly indicate the immunocompetence of the patient and any co-morbid conditions.

Pulmonology

Documentation Requirements

Pulmonary function tests, imaging studies, and response to antifungal therapy.

Common Clinical Scenarios

Patients with chronic cough, hemoptysis, or lung nodules.

Billing Considerations

Ensure that respiratory symptoms are linked to the fungal infection in documentation.

Coding Guidelines

Inclusion Criteria

Use B41.9 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the code is used only when the specific form of paracoccidioidomycosis is not documented
  • Review inclusion criteria for fungal infections and ensure proper documentation of clinical findings

Exclusion Criteria

Do NOT use B41.9 When
No specific exclusions found.

Related CPT Codes

87481CPT Code

Fungal culture

Clinical Scenario

Used when paracoccidioidomycosis is suspected and culture is needed.

Documentation Requirements

Document the reason for the culture and any prior treatments.

Specialty Considerations

Infectious disease specialists should ensure comprehensive documentation of 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 fungal infections, including paracoccidioidomycosis. 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 fungal infections, including paracoccidioidomycosis. 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 fungal infections, including paracoccidioidomycosis. This specificity aids in better tracking of disease prevalence and treatment outcomes.

Resources

Clinical References

  • •
    CDC Fungal Diseases

Coding & Billing References

  • •
    CDC Fungal Diseases

Frequently Asked Questions

What is the primary treatment for paracoccidioidomycosis?

The primary treatment for paracoccidioidomycosis includes antifungal medications such as itraconazole and sulfamethoxazole-trimethoprim. The choice of treatment may depend on the severity of the disease and the patient's immune status.