B59: Pneumocystosis
B59 is a billable, specific ICD-10-CM code for pneumocystosis. It is valid for submission on a claim.
Check B59 with the rest of the claim: free scrubberInclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Pneumonia due to Pneumocystis carinii
- Pneumonia due to Pneumocystis jirovecii
Other codes that can never be billed with B59
Their own Excludes1 notes name this code, so the conflict is not listed above.
Risk adjustment
B59 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
B59 is named in 12 Medicare coverage policies: 12 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A52466Nebulizers - Policy Article
- A56580Billing and Coding: Computerized Axial Tomography (CT), Thorax
- A56717Billing and Coding: Respiratory Therapy (Respiratory Care)
- A57205Billing and Coding: Oximetry Services
Alphabetic index entries that lead here
- Pneumocystis carinii pneumonia
- Pneumocystis jirovecii(pneumonia)
- Pneumocystosis(with pneumonia)
- Infection, infected, infective›Pneumocystis carinii(pneumonia)
- Infection, infected, infective›Pneumocystis jirovecii(pneumonia)
- Pneumonia›plasma cell(of infants)
- Pneumonia›Pneumocystis(carinii) (jirovecii)
- Disease, diseased›protozoal›pneumocystosis
- Pneumonia›in›pneumocystosis(Pneumocystis carinii) (Pneumocystis jirovecii)
- Pneumonia›interstitial›plasma cell
Code history
Unchanged in every release from FY2024 to FY2027.