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v1.0.0
ICD-10 Guide
ICD-10 CodesB48.1

B48.1

Blastomycosis, unspecified

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

Code Description

ICD-10 B48.1 is a billable code used to indicate a diagnosis of blastomycosis, unspecified.

Key Diagnostic Point:

Blastomycosis is a systemic fungal infection caused by the dimorphic fungus Blastomyces dermatitidis, primarily affecting the lungs but can disseminate to other organs. The infection is endemic in certain regions, particularly in North America, where exposure to the fungus occurs through inhalation of spores from contaminated soil or decaying organic matter. Symptoms may range from mild respiratory issues to severe pneumonia, and systemic manifestations can include skin lesions, bone pain, and neurological symptoms. Diagnosis is typically confirmed through culture, serology, or histopathological examination. Treatment often involves antifungal medications such as itraconazole or amphotericin B, especially in immunocompromised patients who are at higher risk for severe disease. The unspecified designation indicates that the specific site or severity of the infection has not been documented, which may complicate treatment decisions and coding accuracy.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and severity of the disease.
  • Need for precise documentation to differentiate from other fungal infections.
  • Potential for misclassification if the site of infection is not specified.
  • Variations in treatment protocols based on patient immunocompetence.

Audit Risk Factors

  • Inadequate documentation of clinical findings.
  • Failure to specify the site of infection.
  • Misuse of unspecified codes leading to potential denials.
  • Inconsistent treatment documentation.

Specialty Focus

Medical Specialties

Infectious Disease

Documentation Requirements

Detailed clinical history, laboratory results, and treatment plans.

Common Clinical Scenarios

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

Billing Considerations

Need for thorough documentation of immunocompromised status and treatment response.

Pulmonology

Documentation Requirements

Pulmonary function tests, imaging studies, and symptom assessments.

Common Clinical Scenarios

Patients with chronic cough, fever, and weight loss.

Billing Considerations

Documentation of differential diagnoses and response to antifungal therapy.

Coding Guidelines

Inclusion Criteria

Use B48.1 When
  • According to ICD
  • 10 guidelines, B48
  • 1 should be used when the specific site of blastomycosis is not documented
  • Coders should ensure that the diagnosis is supported by clinical documentation and that other potential fungal infections are ruled out

Exclusion Criteria

Do NOT use B48.1 When
No specific exclusions found.

Related CPT Codes

87481CPT Code

Fungal culture

Clinical Scenario

Used when a fungal infection is suspected and culture is needed for diagnosis.

Documentation Requirements

Document the reason for the culture and any prior treatments.

Specialty Considerations

Infectious disease specialists may require additional lab results to support diagnosis.

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. B48.1 provides a means to capture cases of blastomycosis that may not have been adequately documented in ICD-9.

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. B48.1 provides a means to capture cases of blastomycosis that may not have been adequately documented in ICD-9.

Reimbursement & Billing Impact

reimbursement processes. B48.1 provides a means to capture cases of blastomycosis that may not have been adequately documented in ICD-9.

Resources

Clinical References

  • •
    CDC - Blastomycosis

Coding & Billing References

  • •
    CDC - Blastomycosis

Frequently Asked Questions

What are the common symptoms of blastomycosis?

Common symptoms include cough, fever, night sweats, weight loss, and skin lesions. Symptoms can vary based on the severity of the infection and the patient's immune status.

How is blastomycosis diagnosed?

Diagnosis is typically made through clinical evaluation, imaging studies, and laboratory tests such as culture or serology to confirm the presence of Blastomyces dermatitidis.

What is the treatment for blastomycosis?

Treatment usually involves antifungal medications such as itraconazole or amphotericin B, depending on the severity of the infection and the patient's overall health.