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ICD-10 Guide
ICD-10 CodesB56.9

B56.9

Leishmaniasis, unspecified

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

Code Description

ICD-10 B56.9 is a billable code used to indicate a diagnosis of leishmaniasis, unspecified.

Key Diagnostic Point:

Leishmaniasis is a parasitic disease caused by protozoa of the genus Leishmania, which are transmitted through the bite of infected sandflies. The disease manifests in various forms, primarily cutaneous, mucocutaneous, and visceral leishmaniasis. The unspecified designation indicates that the specific type of leishmaniasis has not been determined or documented. Symptoms can vary widely depending on the form of the disease, with cutaneous leishmaniasis presenting as skin ulcers, while visceral leishmaniasis may cause fever, weight loss, and splenomegaly. Diagnosis typically involves clinical evaluation, serological tests, and sometimes biopsy of lesions. Treatment protocols vary based on the type and severity of the disease, with options including antimonial compounds, amphotericin B, and miltefosine. The global distribution of leishmaniasis is primarily in tropical and subtropical regions, making it a significant public health concern in endemic areas.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of clinical presentations (cutaneous, visceral, mucocutaneous)
  • Need for specific diagnostic tests to confirm type
  • Potential for co-infections with other tropical diseases
  • Variability in treatment protocols based on disease severity

Audit Risk Factors

  • Inadequate documentation of clinical findings
  • Failure to specify the type of leishmaniasis
  • Lack of travel history documentation
  • Misclassification of leishmaniasis type

Specialty Focus

Medical Specialties

Infectious Disease

Documentation Requirements

Detailed clinical history, diagnostic test results, and treatment plans.

Common Clinical Scenarios

Patients presenting with skin lesions or systemic symptoms after travel to endemic areas.

Billing Considerations

Ensure accurate documentation of the type of leishmaniasis and any co-morbid conditions.

Dermatology

Documentation Requirements

Photographic evidence of lesions, biopsy results, and treatment response.

Common Clinical Scenarios

Patients with cutaneous leishmaniasis presenting with ulcerative lesions.

Billing Considerations

Document the duration and characteristics of lesions for accurate coding.

Coding Guidelines

Inclusion Criteria

Use B56.9 When
  • Follow the official ICD
  • CM coding guidelines for infectious diseases, ensuring specificity in documentation
  • Include relevant travel history and exposure risks

Exclusion Criteria

Do NOT use B56.9 When
  • Exclude conditions that are clearly defined under other codes

Related CPT Codes

87205CPT Code

Smear for protozoa

Clinical Scenario

Used when diagnosing leishmaniasis through skin lesion examination.

Documentation Requirements

Document the site of the smear and findings.

Specialty Considerations

Infectious disease specialists should ensure proper specimen handling.

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 facilitating 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 facilitating 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 facilitating better tracking of disease prevalence and treatment outcomes.

Resources

Clinical References

  • •
    CDC - Leishmaniasis

Coding & Billing References

  • •
    CDC - Leishmaniasis

Frequently Asked Questions

What is the significance of using B56.9?

B56.9 is used when the specific type of leishmaniasis is not documented. It is important to ensure that the clinical context supports this coding choice to avoid audit risks.