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v1.0.0
ICD-10 Guide
ICD-10 CodesB42.89

B42.89

Other forms of sporotrichosis

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

Code Description

ICD-10 B42.89 is a billable code used to indicate a diagnosis of other forms of sporotrichosis.

Key Diagnostic Point:

Sporotrichosis is a fungal infection caused by the dimorphic fungus Sporothrix schenckii, which is commonly found in soil, plants, and decaying organic matter. The infection typically manifests as cutaneous lesions, but can also disseminate to other systems, particularly in immunocompromised patients. Other forms of sporotrichosis may include lymphocutaneous sporotrichosis, which is characterized by nodular lesions that follow lymphatic drainage, and disseminated sporotrichosis, which can affect multiple organs. In immunocompromised individuals, such as those with HIV/AIDS or undergoing chemotherapy, the risk of severe manifestations increases significantly. Diagnosis is primarily clinical, supported by culture or histopathological examination. Treatment usually involves antifungal medications such as itraconazole or potassium iodide, but may require more aggressive therapy in severe cases. Accurate coding for sporotrichosis is essential for proper treatment management and epidemiological tracking.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of clinical presentations requiring careful assessment
  • Differentiation from other fungal infections
  • Need for documentation of immunocompromised status
  • Potential for misclassification with other skin conditions

Audit Risk Factors

  • Inadequate documentation of clinical findings
  • Failure to note immunocompromised status
  • Misuse of related codes leading to upcoding or downcoding
  • Lack of follow-up documentation for treatment efficacy

Specialty Focus

Medical Specialties

Infectious Disease

Documentation Requirements

Detailed clinical history, laboratory results, and treatment plans.

Common Clinical Scenarios

Patients presenting with skin lesions, systemic symptoms, or those with known exposure to potential sources of infection.

Billing Considerations

Ensure documentation reflects the severity and extent of the disease, especially in immunocompromised patients.

Dermatology

Documentation Requirements

Photographic evidence of lesions, biopsy results, and treatment response.

Common Clinical Scenarios

Patients with chronic skin lesions that do not respond to standard treatments.

Billing Considerations

Document the duration of lesions and any prior treatments to support the diagnosis.

Coding Guidelines

Inclusion Criteria

Use B42.89 When
  • Follow ICD
  • CM guidelines for coding fungal infections, ensuring specificity in documentation
  • Include details about the patient's immune status and any relevant comorbidities

Exclusion Criteria

Do NOT use B42.89 When
No specific exclusions found.

Related CPT Codes

11750CPT Code

Excision, skin lesion

Clinical Scenario

When a skin lesion is excised for biopsy to confirm sporotrichosis.

Documentation Requirements

Document the size, location, and characteristics of the lesion.

Specialty Considerations

Ensure the procedure is linked to the diagnosis of sporotrichosis.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of sporotrichosis, improving the accuracy of epidemiological data and treatment tracking.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of sporotrichosis, improving the accuracy of epidemiological data and treatment tracking.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of sporotrichosis, improving the accuracy of epidemiological data and treatment tracking.

Resources

Clinical References

  • •
    CDC Fungal Diseases

Coding & Billing References

  • •
    CDC Fungal Diseases

Frequently Asked Questions

What is sporotrichosis?

Sporotrichosis is a fungal infection caused by Sporothrix schenckii, often presenting as skin lesions but can disseminate in immunocompromised individuals.

How is sporotrichosis treated?

Treatment typically involves antifungal medications such as itraconazole or potassium iodide, with more aggressive therapy required for severe cases.