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v1.0.0
ICD-10 Guide
ICD-10 CodesB43.1

B43.1

ICD-10 title: Pulmonary blastomycosis

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

Code Description

ICD-10 B43.1 is a billable code used to indicate a diagnosis of icd-10 title: pulmonary blastomycosis.

Key Diagnostic Point:

Pulmonary blastomycosis is a fungal infection caused by the organism Blastomyces dermatitidis, primarily affecting the lungs but can disseminate to other organs. It is endemic in certain regions of North America, particularly near waterways. The infection typically occurs after inhalation of airborne spores, leading to a range of respiratory symptoms including cough, chest pain, and fever. In immunocompromised patients, such as those with HIV/AIDS or undergoing immunosuppressive therapy, the risk of severe disease increases significantly. Diagnosis is often confirmed through culture, serology, or histopathological examination of tissue samples. Treatment usually involves antifungal medications, with itraconazole and amphotericin B being the most commonly used agents. Early recognition and appropriate management are crucial to prevent complications, especially in vulnerable populations.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between pulmonary and extrapulmonary forms of blastomycosis.
  • Understanding the immunocompromised status of the patient.
  • Knowledge of antifungal treatment protocols and their implications.
  • Awareness of regional prevalence and risk factors for exposure.

Audit Risk Factors

  • Inadequate documentation of the patient's immunocompromised status.
  • Failure to specify the site of infection (pulmonary vs. disseminated).
  • Incorrect coding of antifungal treatments administered.
  • Lack of follow-up documentation on treatment response.

Specialty Focus

Medical Specialties

Infectious Disease

Documentation Requirements

Detailed patient history, including exposure risks and immunocompromised status.

Common Clinical Scenarios

Patients presenting with respiratory symptoms and a history of exposure to endemic areas.

Billing Considerations

Consideration of co-morbid conditions that may affect treatment choices.

Pulmonology

Documentation Requirements

Pulmonary function tests and imaging studies to assess lung involvement.

Common Clinical Scenarios

Patients with chronic cough, hemoptysis, or pneumonia-like symptoms.

Billing Considerations

Documentation of lung imaging findings and response to antifungal therapy.

Coding Guidelines

Inclusion Criteria

Use B43.1 When
  • Follow official ICD
  • 10 coding guidelines, ensuring accurate documentation of the site of infection and any underlying immunocompromised conditions
  • Include relevant clinical findings and treatment details to support the diagnosis

Exclusion Criteria

Do NOT use B43.1 When
No specific exclusions found.

Related CPT Codes

87481CPT Code

Fungal culture, respiratory specimen

Clinical Scenario

Used when a patient presents with respiratory symptoms and a suspected fungal infection.

Documentation Requirements

Document the clinical rationale for the test and any relevant history.

Specialty Considerations

Infectious disease specialists may require additional lab results for comprehensive management.

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, improving the accuracy of data collection and reimbursement processes for conditions like pulmonary blastomycosis.

ICD-9 vs ICD-10

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

Reimbursement & Billing Impact

reimbursement processes for conditions like pulmonary blastomycosis.

Resources

Clinical References

  • •
    CDC Blastomycosis Information

Coding & Billing References

  • •
    CDC Blastomycosis Information

Frequently Asked Questions

What are the common symptoms of pulmonary blastomycosis?

Common symptoms include cough, chest pain, fever, and difficulty breathing. In some cases, it may present similarly to pneumonia.

How is pulmonary blastomycosis diagnosed?

Diagnosis is typically made through a combination of clinical evaluation, imaging studies, and laboratory tests, including cultures and serological assays.