B37.1: Pulmonary candidiasis
B37.1 is a billable, specific ICD-10-CM code for pulmonary candidiasis. It is valid for submission on a claim.
Check B37.1 with the rest of the claim: free scrubberCode also
Both codes may be needed to describe the encounter fully. Sequencing depends on the reason for the visit.
- , if applicable:
- pulmonary mycetoma (J4B)
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Candidal bronchitis
- Candidal pneumonia
Other codes that can never be billed with B37.1
Their own Excludes1 notes name this code, so the conflict is not listed above.
Risk adjustment
B37.1 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 6 Opportunistic Infections0.381 RAF
Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score. Look up the whole chart to see which of its HCCs the hierarchy would zero.
Medicare coverage
B37.1 is named in 2 Medicare coverage policies: 2 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A56717Billing and Coding: Respiratory Therapy (Respiratory Care)
- A57224Billing and Coding: Respiratory Care
Alphabetic index entries that lead here
- Bronchomycosis NOS›candidal
- Candidiasis, candidal›bronchitis
- Candidiasis, candidal›lung
- Candidiasis, candidal›pneumonia
- Candidiasis, candidal›pulmonary
- Pneumonia›Candida
- Pneumonia›in›candidiasis
Code history
Unchanged in every release from FY2024 to FY2027.