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ICD-10 Guide
ICD-10 CodesB55.1

B55.1

Leishmaniasis recidivans

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

Code Description

ICD-10 B55.1 is a billable code used to indicate a diagnosis of leishmaniasis recidivans.

Key Diagnostic Point:

Leishmaniasis recidivans is a chronic form of leishmaniasis caused by the protozoan parasites of the genus Leishmania, primarily transmitted through the bite of infected sandflies. This condition is characterized by recurrent skin lesions that may appear after a period of apparent healing. The lesions can be ulcerative and are often accompanied by systemic symptoms such as fever, malaise, and lymphadenopathy. The recidivans form is particularly noted for its tendency to recur in the same location, often in individuals who have previously been treated for leishmaniasis. Diagnosis is typically made through clinical evaluation, serological tests, and sometimes biopsy of the lesions. Treatment usually involves the use of antimonial compounds, amphotericin B, or miltefosine, depending on the severity and extent of the disease. The management of leishmaniasis recidivans requires careful monitoring and may necessitate multiple treatment courses to achieve resolution of symptoms and prevent further recurrences.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of clinical presentations and symptoms
  • Need for accurate documentation of prior treatments
  • Differentiation from other forms of leishmaniasis
  • Potential for co-infections or complications

Audit Risk Factors

  • Inadequate documentation of prior leishmaniasis treatments
  • Failure to specify the chronic nature of the condition
  • Misclassification of the type of leishmaniasis
  • Lack of supporting clinical evidence for recurrent lesions

Specialty Focus

Medical Specialties

Infectious Disease

Documentation Requirements

Detailed history of previous infections, treatment responses, and current symptoms.

Common Clinical Scenarios

Patients presenting with recurrent skin lesions after treatment for leishmaniasis.

Billing Considerations

Consideration of co-morbid conditions that may complicate treatment.

Dermatology

Documentation Requirements

Photographic evidence of lesions, detailed descriptions of lesion characteristics.

Common Clinical Scenarios

Patients with chronic skin lesions that may be misdiagnosed as other dermatological conditions.

Billing Considerations

Differentiation from other skin conditions such as cutaneous sarcoidosis or granuloma annulare.

Coding Guidelines

Inclusion Criteria

Use B55.1 When
  • Follow the official ICD
  • CM coding guidelines for infectious diseases, ensuring accurate documentation of the condition's chronic nature and any previous treatments
  • Include relevant clinical findings and laboratory results

Exclusion Criteria

Do NOT use B55.1 When
No specific exclusions found.

Related CPT Codes

88305CPT Code

Pathology examination of skin biopsy

Clinical Scenario

Used when a biopsy is performed to confirm leishmaniasis.

Documentation Requirements

Pathology report and clinical notes supporting the need for biopsy.

Specialty Considerations

Infectious disease specialists should ensure that the biopsy is clearly linked to the diagnosis.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of leishmaniasis, including the differentiation of recidivans from other forms, improving data accuracy and treatment tracking.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of leishmaniasis, including the differentiation of recidivans from other forms, improving data accuracy and treatment tracking.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of leishmaniasis, including the differentiation of recidivans from other forms, improving data accuracy and treatment tracking.

Resources

Clinical References

  • •
    CDC - Leishmaniasis

Coding & Billing References

  • •
    CDC - Leishmaniasis

Frequently Asked Questions

What is the primary cause of leishmaniasis recidivans?

Leishmaniasis recidivans is primarily caused by the protozoan parasite Leishmania braziliensis, transmitted through the bite of infected sandflies.