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v1.0.0
ICD-10 Guide
ICD-10 CodesB55.0

B55.0

Leishmaniasis visceral

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

Code Description

ICD-10 B55.0 is a billable code used to indicate a diagnosis of leishmaniasis visceral.

Key Diagnostic Point:

Leishmaniasis visceral, also known as kala-azar, is a severe form of leishmaniasis caused by protozoan parasites of the genus Leishmania, primarily Leishmania donovani and Leishmania infantum. This disease is transmitted through the bite of infected female phlebotomine sandflies. The clinical presentation includes prolonged fever, weight loss, splenomegaly, hepatomegaly, and anemia. If left untreated, visceral leishmaniasis can be fatal, with a mortality rate exceeding 90% in untreated cases. Diagnosis is typically confirmed through serological tests, bone marrow aspiration, or splenic aspirate. Treatment protocols often involve the use of antimonial compounds, amphotericin B, or miltefosine, depending on the severity of the disease and the patient's health status. Early diagnosis and treatment are crucial to improving outcomes and reducing morbidity and mortality associated with this tropical disease.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of clinical presentations and symptoms
  • Differential diagnosis with other tropical diseases
  • Need for specific laboratory confirmation
  • Potential for co-infections (e.g., HIV)

Audit Risk Factors

  • Inadequate documentation of laboratory results
  • Failure to document travel history to endemic areas
  • Misdiagnosis due to overlapping symptoms with other diseases
  • Lack of detailed treatment plans

Specialty Focus

Medical Specialties

Infectious Disease

Documentation Requirements

Detailed clinical notes, laboratory results, and treatment plans must be documented.

Common Clinical Scenarios

Patients presenting with fever, splenomegaly, and weight loss after travel to endemic regions.

Billing Considerations

Ensure all laboratory tests are documented to support the diagnosis.

Hematology

Documentation Requirements

Complete blood counts and any relevant hematological findings should be included.

Common Clinical Scenarios

Patients with anemia and splenomegaly requiring evaluation for underlying causes.

Billing Considerations

Document any blood transfusions or treatments related to anemia.

Coding Guidelines

Inclusion Criteria

Use B55.0 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the diagnosis is supported by clinical documentation and laboratory results
  • Include any relevant co
  • morbid conditions that may affect treatment

Exclusion Criteria

Do NOT use B55.0 When
No specific exclusions found.

Related CPT Codes

88305CPT Code

Pathology examination of tissue

Clinical Scenario

Used when a biopsy is performed to confirm leishmaniasis.

Documentation Requirements

Pathology report must be included.

Specialty Considerations

Infectious disease specialists should ensure proper documentation of the biopsy site.

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 data accuracy and enabling better tracking of disease prevalence and treatment outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of leishmaniasis, improving data accuracy and enabling better tracking of disease prevalence and treatment outcomes.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of leishmaniasis, improving data accuracy and enabling better tracking of disease prevalence and treatment outcomes.

Resources

Clinical References

  • •
    CDC - Leishmaniasis

Coding & Billing References

  • •
    CDC - Leishmaniasis

Frequently Asked Questions

What are the common symptoms of visceral leishmaniasis?

Common symptoms include prolonged fever, weight loss, splenomegaly, hepatomegaly, and anemia. Patients may also experience fatigue and night sweats.