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ICD-10 Guide
ICD-10 CodesB42.1

B42.1

ICD-10 Title: Pulmonary coccidioidomycosis

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

Code Description

ICD-10 B42.1 is a billable code used to indicate a diagnosis of icd-10 title: pulmonary coccidioidomycosis.

Key Diagnostic Point:

Pulmonary coccidioidomycosis, commonly known as valley fever, is a fungal infection caused by the inhalation of spores from the Coccidioides species, primarily C. immitis and C. posadasii. This condition predominantly affects the lungs and can lead to a range of respiratory symptoms, including cough, chest pain, fever, and fatigue. In immunocompromised patients, such as those with HIV/AIDS, cancer, or those on immunosuppressive therapy, the risk of severe disease increases significantly. The infection can progress to disseminated coccidioidomycosis, affecting other organs and leading to more severe complications. Diagnosis is typically confirmed through serological tests, culture, or histopathological examination. Treatment often involves antifungal medications such as fluconazole or itraconazole, especially in cases of moderate to severe disease or in immunocompromised individuals. Early recognition and appropriate management are crucial to prevent complications and improve patient outcomes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between pulmonary and disseminated forms of coccidioidomycosis.
  • Understanding the immunocompromised status of the patient and its implications for treatment.
  • Navigating the various antifungal treatments and their indications.
  • Documenting the clinical presentation accurately to support the diagnosis.

Audit Risk Factors

  • Inadequate documentation of the patient's immunocompromised status.
  • Failure to document the specific antifungal treatment prescribed.
  • Misclassification of the infection as a superficial fungal infection.
  • Lack of follow-up documentation to support ongoing treatment.

Specialty Focus

Medical Specialties

Infectious Disease

Documentation Requirements

Detailed clinical notes on the patient's history, symptoms, and diagnostic tests.

Common Clinical Scenarios

Patients presenting with respiratory symptoms in endemic areas, particularly in immunocompromised individuals.

Billing Considerations

Consideration of alternative diagnoses and the need for comprehensive follow-up.

Pulmonology

Documentation Requirements

Pulmonary function tests and imaging studies to assess lung involvement.

Common Clinical Scenarios

Patients with chronic cough and respiratory distress, especially in endemic regions.

Billing Considerations

Documentation of any pulmonary complications and response to treatment.

Coding Guidelines

Inclusion Criteria

Use B42.1 When
  • According to the official coding guidelines, B42
  • 1 should be used when the clinical documentation supports a diagnosis of pulmonary coccidioidomycosis
  • It is important to include details about the patient's immune status and any relevant diagnostic tests performed

Exclusion Criteria

Do NOT use B42.1 When
No specific exclusions found.

Related CPT Codes

87481CPT Code

Coccidioides antibody test

Clinical Scenario

Used to confirm diagnosis in patients with respiratory symptoms.

Documentation Requirements

Document the reason for testing and the patient's clinical presentation.

Specialty Considerations

Infectious disease specialists should ensure comprehensive documentation of test results.

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 pulmonary coccidioidomycosis, improving the accuracy of data collection and reimbursement processes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of fungal infections, including pulmonary coccidioidomycosis, improving the accuracy of data collection and reimbursement processes.

Reimbursement & Billing Impact

reimbursement processes.

Resources

Clinical References

  • •
    CDC - Coccidioidomycosis

Coding & Billing References

  • •
    CDC - Coccidioidomycosis

Frequently Asked Questions

What are the common symptoms of pulmonary coccidioidomycosis?

Common symptoms include cough, fever, chest pain, and fatigue. In some cases, patients may experience more severe respiratory distress.

How is pulmonary coccidioidomycosis diagnosed?

Diagnosis is typically made through a combination of clinical evaluation, serological testing, and imaging studies such as chest X-rays or CT scans.

What antifungal treatments are used for pulmonary coccidioidomycosis?

First-line treatments include fluconazole and itraconazole, especially in moderate to severe cases or in immunocompromised patients.