ICD-10 Coding for Candida Infection(B37.0, B37.3, B37.7)
Complete ICD-10-CM coding and documentation guide for Candida Infection. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Candida Infection
B37.0-B37.9Primary Range
Candidiasis
This range covers all forms of candidiasis, including oral, vulvovaginal, and systemic infections.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| B37.0 | Candidal stomatitis | Use when oral thrush is confirmed by lab tests. |
|
| B37.3 | Candidiasis of vulva and vagina | Use when vulvovaginal candidiasis is confirmed by KOH prep. |
|
| B37.7 | Candidal sepsis | Use when sepsis is confirmed to be due to Candida. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: How to code Candida UTI with sepsis?
Essential facts and insights about Candida Infection
Primary ICD-10-CM Codes for candida infection
Decision Criteria
clinical Criteria
- Presence of white plaques confirmed by lab tests
Applicable To
- Oral thrush
Excludes
- Neonatal candidiasis (P37.5)
Clinical Validation Requirements
- White plaques on tongue/mucosa with microscopy/Culture/PCR confirmation
Code-Specific Risks
- Misdiagnosis if not confirmed by lab tests
Coding Notes
- Ensure lab confirmation is documented.
B37.3 - Candidiasis of vulva and vagina
Use when vulvovaginal candidiasis is confirmed by KOH prep.
Applicable To
- Vulvovaginal candidiasis
Excludes
- Bacterial vaginosis
Clinical Validation Requirements
- Pruritus, curd-like discharge plus KOH prep showing pseudohyphae
Coding Notes
Document lab confirmation and symptoms.
B37.7 - Candidal sepsis
Use when sepsis is confirmed to be due to Candida.
Applicable To
- Sepsis due to Candida
Excludes
- Sepsis due to other organisms
Clinical Validation Requirements
- Blood cultures positive for Candida species
Coding Notes
Ensure blood culture results are documented.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Severe sepsis without shock
R65.20Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Candida Infection to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code B37.0.
Impact
Clinical: Ambiguous diagnosis, Regulatory: Non-compliance with documentation standards, Financial: Potential for denied claims
Mitigation Strategy
Specify site of infection, Include lab confirmation
Impact
Reimbursement: Incorrect DRG assignment, Compliance: Non-compliance with coding guidelines, Data Quality: Inaccurate clinical data
Mitigation Strategy
Use B37.0 for oral candidiasis.
Impact
Risk of incorrect coding without blood culture documentation
Mitigation Strategy
Ensure blood culture results are documented before coding.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Candida Infection, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Candida Infection
Use these documentation templates to ensure complete and accurate documentation for Candida Infection. These templates include all required elements for proper coding and billing.
Vulvovaginal Candidiasis
Specialty: GynecologyRequired Elements
- History of symptoms
- Physical exam findings
- Lab test results
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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