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v1.0.0
ICD-10 Guide
ICD-10 CodesB45.3

B45.3

Chronic mucocutaneous candidiasis

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

Code Description

ICD-10 B45.3 is a billable code used to indicate a diagnosis of chronic mucocutaneous candidiasis.

Key Diagnostic Point:

Chronic mucocutaneous candidiasis (CMC) is a persistent fungal infection characterized by the overgrowth of Candida species, primarily Candida albicans, affecting the skin, nails, and mucous membranes. This condition is often seen in immunocompromised patients, particularly those with underlying endocrine disorders such as diabetes mellitus or those on immunosuppressive therapy. Clinically, CMC presents with symptoms such as white patches in the oral cavity (oral thrush), chronic nail infections, and skin lesions that may be itchy or painful. The diagnosis is typically confirmed through clinical examination and microbiological cultures. Treatment involves the use of antifungal agents, including topical treatments like clotrimazole or systemic therapies such as fluconazole or itraconazole, depending on the severity and extent of the infection. Management of CMC also requires addressing any underlying immunosuppressive conditions to prevent recurrence. Regular follow-up is essential to monitor treatment efficacy and adjust therapy as needed.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires understanding of immunocompromised states
  • Differentiation from other fungal infections
  • Need for comprehensive patient history
  • Potential for multiple co-morbid conditions

Audit Risk Factors

  • Inadequate documentation of immunocompromised status
  • Failure to document treatment plans and responses
  • Misclassification of the condition as acute candidiasis
  • Lack of follow-up notes indicating ongoing management

Specialty Focus

Medical Specialties

Infectious Disease

Documentation Requirements

Detailed patient history, including immunocompromised status and previous treatments.

Common Clinical Scenarios

Patients with recurrent candidiasis, particularly those with diabetes or on immunosuppressive therapy.

Billing Considerations

Need for thorough documentation of treatment response and any changes in immunocompromised status.

Dermatology

Documentation Requirements

Clinical photographs of lesions, detailed descriptions of skin findings.

Common Clinical Scenarios

Patients presenting with skin lesions suggestive of candidiasis.

Billing Considerations

Differentiation from other dermatological conditions that may mimic candidiasis.

Coding Guidelines

Inclusion Criteria

Use B45.3 When
  • According to ICD
  • 10 coding guidelines, B45
  • 3 should be used when the condition is chronic and involves mucocutaneous surfaces
  • It is important to document the patient's immunocompromised status and any relevant co
  • morbidities

Exclusion Criteria

Do NOT use B45.3 When
No specific exclusions found.

Related CPT Codes

87101CPT Code

Culture, fungal

Clinical Scenario

Used to confirm diagnosis of candidiasis.

Documentation Requirements

Document the reason for the culture and any previous treatments.

Specialty Considerations

Infectious disease specialists may order this more frequently.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of chronic mucocutaneous candidiasis, improving the accuracy of data collection and reimbursement processes for healthcare providers.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of chronic mucocutaneous candidiasis, improving the accuracy of data collection and reimbursement processes for healthcare providers.

Reimbursement & Billing Impact

reimbursement processes for healthcare providers.

Resources

Clinical References

  • •
    CDC - Fungal Diseases

Coding & Billing References

  • •
    CDC - Fungal Diseases

Frequently Asked Questions

What is chronic mucocutaneous candidiasis?

Chronic mucocutaneous candidiasis is a persistent fungal infection caused by Candida species, primarily affecting the skin, nails, and mucous membranes, often seen in immunocompromised patients.

How is chronic mucocutaneous candidiasis treated?

Treatment typically involves antifungal medications, both topical and systemic, depending on the severity of the infection, along with management of any underlying immunocompromised conditions.