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v1.0.0
ICD-10 Guide
ICD-10 CodesB45

B45

Cryptococcosis

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

Code Description

ICD-10 B45 is a billable code used to indicate a diagnosis of cryptococcosis.

Key Diagnostic Point:

Cryptococcosis is a fungal infection caused by the yeast Cryptococcus neoformans, primarily affecting immunocompromised individuals, such as those with HIV/AIDS, organ transplant recipients, and patients on immunosuppressive therapy. The infection typically manifests in the lungs, leading to pneumonia-like symptoms, but it can disseminate to the central nervous system, resulting in cryptococcal meningitis, which is a life-threatening condition. Symptoms may include cough, chest pain, fever, and neurological signs such as headache, confusion, and altered mental status. Diagnosis is often confirmed through culture of the organism from respiratory secretions or cerebrospinal fluid, as well as serological tests for cryptococcal antigen. Treatment involves antifungal medications, primarily amphotericin B and flucytosine for severe cases, followed by maintenance therapy with fluconazole. Early diagnosis and appropriate antifungal therapy are crucial for improving outcomes, especially in high-risk populations.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between pulmonary and disseminated cryptococcosis
  • Identifying immunocompromised status of the patient
  • Understanding the need for additional codes for complications like meningitis
  • Navigating the use of antifungal treatment codes

Audit Risk Factors

  • Inadequate documentation of immunocompromised status
  • Failure to document the site of infection (pulmonary vs. CNS)
  • Incorrect coding of antifungal treatments
  • Omission of related complications

Specialty Focus

Medical Specialties

Infectious Disease

Documentation Requirements

Detailed clinical notes on the patient's immunocompromised status, symptoms, diagnostic tests, and treatment plans.

Common Clinical Scenarios

Patients presenting with respiratory symptoms and a history of HIV/AIDS or recent organ transplant.

Billing Considerations

Ensure that all relevant lab results and imaging studies are documented to support the diagnosis.

Pulmonology

Documentation Requirements

Thorough documentation of respiratory symptoms, diagnostic imaging findings, and response to treatment.

Common Clinical Scenarios

Patients with pneumonia-like symptoms and a known history of cryptococcal infection.

Billing Considerations

Document any co-existing lung conditions that may complicate the diagnosis.

Coding Guidelines

Inclusion Criteria

Use B45 When
  • Follow the official ICD
  • CM coding guidelines for infectious diseases, ensuring accurate documentation of the patient's immunocompromised status and any complications
  • Include additional codes for associated conditions as necessary

Exclusion Criteria

Do NOT use B45 When
No specific exclusions found.

Related Codes

Child Codes

7 codes
B45.0
Meningitis due to coxsackievirus
B45.1
Cryptococcal meningitis
B45.2
Cryptococcal meningitis
B45.3
Chronic mucocutaneous candidiasis
B45.7
Cryptococcosis, unspecified
B45.8
Cryptococcosis, unspecified
B45.9
Cryptococcosis, unspecified

Related CPT Codes

87481CPT Code

Cryptococcus neoformans antigen test

Clinical Scenario

Used to confirm diagnosis in patients with suspected cryptococcosis.

Documentation Requirements

Document the indication for the test and results.

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 cryptococcosis, enabling better tracking of the disease and its complications, which is crucial for epidemiological studies and treatment outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of cryptococcosis, enabling better tracking of the disease and its complications, which is crucial for epidemiological studies and treatment outcomes.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of cryptococcosis, enabling better tracking of the disease and its complications, which is crucial for epidemiological studies and treatment outcomes.

Resources

Clinical References

  • •
    CDC Fungal Diseases

Coding & Billing References

  • •
    CDC Fungal Diseases

Frequently Asked Questions

What are the common symptoms of cryptococcosis?

Common symptoms include cough, fever, chest pain, and neurological symptoms such as headache and confusion, especially in cases of meningitis.

How is cryptococcosis diagnosed?

Diagnosis is typically made through culture of the organism from respiratory secretions or cerebrospinal fluid, along with serological tests for cryptococcal antigen.

What is the treatment for cryptococcosis?

Treatment usually involves antifungal medications such as amphotericin B and flucytosine for severe cases, followed by maintenance therapy with fluconazole.