B45.9: Cryptococcosis, unspecified

Risk adjustment

B45.9 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

B45.9 is named in 3 Medicare coverage policies: 3 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

• A56580Billing and Coding: Computerized Axial Tomography (CT), Thorax
• A56612Billing and Coding: CT of the Head
• A57672Billing and Coding: Nail Debridement