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v1.0.0
ICD-10 Guide
ICD-10 CodesB60.1

B60.1

B60.1 - Malignant malaria

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

Code Description

ICD-10 B60.1 is a billable code used to indicate a diagnosis of b60.1 - malignant malaria.

Key Diagnostic Point:

Malignant malaria, primarily caused by Plasmodium falciparum, is a severe form of malaria characterized by high parasitemia and significant morbidity and mortality. This protozoal infection is transmitted through the bite of infected Anopheles mosquitoes and is endemic in tropical and subtropical regions. Patients typically present with symptoms such as high fever, chills, sweating, headache, nausea, vomiting, and abdominal pain. Severe cases may lead to complications like cerebral malaria, acute respiratory distress syndrome (ARDS), and multi-organ failure. Diagnosis is confirmed through blood smears or rapid diagnostic tests that detect malaria antigens. Treatment involves the use of antimalarial medications, with artemisinin-based combination therapies (ACTs) being the first-line treatment. In severe cases, intravenous administration of quinine or artesunate may be necessary. Prompt diagnosis and treatment are crucial to reduce the risk of complications and improve patient outcomes.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Differentiating between types of malaria (e.g., benign vs. malignant)
  • Understanding the severity of the infection and associated complications
  • Knowledge of treatment protocols and their documentation
  • Awareness of endemic regions and travel history

Audit Risk Factors

  • Inadequate documentation of travel history or exposure to endemic areas
  • Failure to document the severity of the infection
  • Misclassification of malaria type
  • Lack of supporting lab results for diagnosis

Specialty Focus

Medical Specialties

Infectious Disease

Documentation Requirements

Detailed clinical notes on symptoms, lab results, and treatment plans.

Common Clinical Scenarios

Patients presenting with fever and travel history to endemic regions.

Billing Considerations

Ensure documentation reflects the severity and any complications of malaria.

Emergency Medicine

Documentation Requirements

Immediate assessment notes, lab results, and treatment administered.

Common Clinical Scenarios

Patients with acute febrile illness and suspected malaria.

Billing Considerations

Timely documentation is critical for accurate coding and treatment.

Coding Guidelines

Inclusion Criteria

Use B60.1 When
  • Follow ICD
  • CM guidelines for coding infectious diseases
  • Include specific documentation of the type of malaria, severity, and any complications
  • Ensure that the diagnosis is supported by laboratory findings

Exclusion Criteria

Do NOT use B60.1 When
No specific exclusions found.

Related CPT Codes

87430CPT Code

Malaria antigen detection test

Clinical Scenario

Used for rapid diagnosis of malaria in patients presenting with fever.

Documentation Requirements

Document the reason for the test and results.

Specialty Considerations

Infectious disease specialists should ensure accurate interpretation of test results.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of malaria types, improving the accuracy of data collection and reimbursement processes. B60.1 provides a clear distinction for malignant malaria, which is critical for treatment and epidemiological tracking.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of malaria types, improving the accuracy of data collection and reimbursement processes. B60.1 provides a clear distinction for malignant malaria, which is critical for treatment and epidemiological tracking.

Reimbursement & Billing Impact

reimbursement processes. B60.1 provides a clear distinction for malignant malaria, which is critical for treatment and epidemiological tracking.

Resources

Clinical References

  • •
    CDC Malaria Information

Coding & Billing References

  • •
    CDC Malaria Information

Frequently Asked Questions

What is the primary cause of malignant malaria?

Malignant malaria is primarily caused by the protozoan parasite Plasmodium falciparum, which is known for its severe clinical manifestations.