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ICD-10 Guide
ICD-10 CodesB55

B55

Leishmaniasis

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

Code Description

ICD-10 B55 is a billable code used to indicate a diagnosis of leishmaniasis.

Key Diagnostic Point:

Leishmaniasis is a parasitic disease caused by protozoa of the genus Leishmania, transmitted through the bite of infected female phlebotomine sandflies. The disease manifests in various forms, primarily cutaneous leishmaniasis, which causes skin lesions, and visceral leishmaniasis, which affects internal organs such as the liver and spleen. The clinical presentation can vary significantly based on the species of Leishmania involved and the host's immune response. Cutaneous leishmaniasis typically presents with one or more ulcers on the skin, while visceral leishmaniasis may present with fever, weight loss, anemia, and splenomegaly. Diagnosis is primarily through clinical evaluation and laboratory tests, including serological tests and PCR. Treatment options vary depending on the form of the disease and may include antimonial compounds, amphotericin B, or miltefosine. Early diagnosis and treatment are crucial to prevent complications, especially in cases of visceral leishmaniasis, which can be fatal if left untreated.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of clinical presentations (cutaneous vs. visceral)
  • Differential diagnosis with other tropical diseases
  • Need for accurate laboratory confirmation
  • Variability in treatment protocols based on disease form

Audit Risk Factors

  • Inconsistent documentation of clinical findings
  • Failure to specify the form of leishmaniasis
  • Lack of laboratory confirmation in records
  • Inadequate treatment documentation

Specialty Focus

Medical Specialties

Infectious Disease

Documentation Requirements

Detailed clinical history, laboratory results, and treatment plans.

Common Clinical Scenarios

Diagnosis and management of cutaneous and visceral leishmaniasis.

Billing Considerations

Ensure accurate documentation of travel history and exposure to endemic areas.

Dermatology

Documentation Requirements

Photographic evidence of skin lesions and treatment response.

Common Clinical Scenarios

Management of cutaneous leishmaniasis with topical or systemic therapies.

Billing Considerations

Document the size, location, and number of lesions for accurate coding.

Coding Guidelines

Inclusion Criteria

Use B55 When
  • Follow the official ICD
  • CM guidelines for coding infectious and parasitic diseases
  • Ensure to document the specific type of leishmaniasis and any associated complications
  • infection is confirmed

Exclusion Criteria

Do NOT use B55 When
  • Exclude codes for other protozoal infections unless co

Related Codes

Child Codes

4 codes
B55.0
Leishmaniasis visceral
B55.1
Leishmaniasis recidivans
B55.2
Toxoplasma chorioretinitis
B55.9
Leishmaniasis, unspecified

Related CPT Codes

87210CPT Code

Smear, parasite, blood or tissue

Clinical Scenario

Used for laboratory confirmation of leishmaniasis.

Documentation Requirements

Document the type of specimen and results.

Specialty Considerations

Infectious disease specialists should ensure accurate lab results are included.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of leishmaniasis, improving the accuracy of data collection and reimbursement processes. It has also facilitated better tracking of tropical diseases.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of leishmaniasis, improving the accuracy of data collection and reimbursement processes. It has also facilitated better tracking of tropical diseases.

Reimbursement & Billing Impact

reimbursement processes. It has also facilitated better tracking of tropical diseases.

Resources

Clinical References

  • •
    CDC - Leishmaniasis

Coding & Billing References

  • •
    CDC - Leishmaniasis

Frequently Asked Questions

What are the common symptoms of leishmaniasis?

Common symptoms include skin ulcers for cutaneous leishmaniasis and fever, weight loss, and splenomegaly for visceral leishmaniasis.

How is leishmaniasis diagnosed?

Diagnosis is typically made through clinical evaluation, serological tests, and PCR to confirm the presence of Leishmania parasites.