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v1.0.0
ICD-10 Guide
ICD-10 CodesB45.1

B45.1

Cryptococcal meningitis

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

Code Description

ICD-10 B45.1 is a billable code used to indicate a diagnosis of cryptococcal meningitis.

Key Diagnostic Point:

Cryptococcal meningitis is a serious fungal infection of the central nervous system caused by the encapsulated yeast Cryptococcus neoformans. This condition primarily affects immunocompromised individuals, particularly those with HIV/AIDS, but can also occur in patients receiving immunosuppressive therapy or with other underlying conditions that compromise the immune system. The infection typically arises from inhalation of airborne spores, which can disseminate to the central nervous system, leading to inflammation of the meninges. Symptoms may include fever, headache, neck stiffness, nausea, vomiting, and altered mental status. Diagnosis is confirmed through lumbar puncture and analysis of cerebrospinal fluid (CSF), which may show elevated opening pressure, lymphocytic pleocytosis, and the presence of cryptococcal antigen. Treatment involves antifungal therapy, primarily with amphotericin B and flucytosine, followed by maintenance therapy with fluconazole. Early diagnosis and treatment are crucial to improve outcomes and reduce morbidity and mortality associated with this condition.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Requires understanding of fungal infections and their implications in immunocompromised patients.
  • Differentiation from other types of meningitis (bacterial, viral).
  • Need for accurate documentation of immunocompromised status.
  • Potential for co-infection with other pathogens.

Audit Risk Factors

  • Inadequate documentation of immunocompromised status.
  • Failure to document the specific antifungal treatment regimen.
  • Misclassification of the type of meningitis.
  • Lack of supporting lab results in the medical record.

Specialty Focus

Medical Specialties

Infectious Disease

Documentation Requirements

Detailed history of immunocompromised status, lab results, and treatment plans.

Common Clinical Scenarios

Patients presenting with fever and neurological symptoms, particularly in those with HIV/AIDS.

Billing Considerations

Ensure thorough documentation of all diagnostic tests and treatments to support coding.

Neurology

Documentation Requirements

Neurological examination findings, imaging studies, and CSF analysis results.

Common Clinical Scenarios

Patients with altered mental status and signs of meningitis.

Billing Considerations

Document any differential diagnoses considered and ruled out.

Coding Guidelines

Inclusion Criteria

Use B45.1 When
  • Follow official ICD
  • 10 coding guidelines, ensuring accurate documentation of the patient's immunocompromised status and the specific treatment regimen
  • Include any relevant lab results and clinical findings that support the diagnosis

Exclusion Criteria

Do NOT use B45.1 When
No specific exclusions found.

Related CPT Codes

62270CPT Code

Lumbar puncture

Clinical Scenario

Used for diagnosis of meningitis.

Documentation Requirements

Document indication for procedure and CSF findings.

Specialty Considerations

Ensure that the procedure is performed by a qualified provider.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of cryptococcal meningitis, improving the ability to capture the complexity of the condition and its treatment, which can impact reimbursement and care management.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of cryptococcal meningitis, improving the ability to capture the complexity of the condition and its treatment, which can impact reimbursement and care management.

Reimbursement & Billing Impact

reimbursement and care management.

Resources

Clinical References

  • •
    CDC Cryptococcal Meningitis Information

Coding & Billing References

  • •
    CDC Cryptococcal Meningitis Information

Frequently Asked Questions

What is the primary treatment for cryptococcal meningitis?

The primary treatment involves antifungal therapy, typically starting with amphotericin B and flucytosine, followed by maintenance therapy with fluconazole.