B35-B49 — Mycoses
ICD-10-CM codes B35-B49 cover mycoses, within certain infectious and parasitic diseases. The block holds 125 codes across 15 categories, of which 104 are billable and 21 are header codes that cannot be submitted on a claim.
Risk adjustment in B35-B49
0 codes in this block map to a CMS-HCC, which means the diagnosis carries a risk-adjustment payment when it is documented and coded. Under-coding here is money left on the table; over-coding here is what audits are for.
- HCC 6 Opportunistic Infections
- HCC 2 Septicemia, Sepsis, Systemic Inflammatory Response Syndrome/Shock
- HCC 92 Bone/Joint/Muscle/Severe Soft Tissue Infections/Necrosis
- HCC 280 Chronic Obstructive Pulmonary Disease, Interstitial Lung Disorders, and Other Chronic Lung Disorders
What else to watch in B35-B49
- 72 codes are named in Medicare coverage policies. An LCD or NCD lists them as supporting medical necessity, or explicitly as not supporting it. Which applies depends on the MAC for your state.
Categories in B35-B49
- B35Dermatophytosis
- B36Other superficial mycoses
- B37Candidiasis
- B38Coccidioidomycosis
- B39Histoplasmosis
- B40Blastomycosis
- B41Paracoccidioidomycosis
- B42Sporotrichosis
- B43Chromomycosis and pheomycotic abscess
- B44Aspergillosis
- B45Cryptococcosis
- B46Zygomycosis
- B47Mycetoma
- B48Other mycoses, not elsewhere classified
- B49Unspecified mycosis