ICD-10 Coding for Candidemia(B37.7, B37.89)
Complete ICD-10-CM coding and documentation guide for Candidemia. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Candidemia
B37.0-B37.9Primary Range
Candidiasis
This range includes all forms of candidiasis, with B37.7 specifically for candidal sepsis, which is the primary code for candidemia.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| B37.7 | Candidal sepsis | Use when blood cultures confirm Candida species and systemic signs of sepsis are present. |
|
| B37.89 | Other forms of candidiasis | Use when specific Candida species are identified in lab results. |
|
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: ICD-10 code for candidemia
Essential facts and insights about Candidemia
Primary ICD-10-CM Codes for candidemia
Decision Criteria
clinical Criteria
- Positive blood culture for Candida species with systemic symptoms
documentation Criteria
- Explicit mention of 'candidal sepsis' or 'candidemia' in medical records
Applicable To
- Candidemia
Excludes
- Other forms of sepsis not caused by Candida
Clinical Validation Requirements
- Positive blood culture for Candida species
- Systemic inflammatory response (e.g., fever, hypotension)
- Initiation of antifungal treatment
Code-Specific Risks
- Confusion with B37.9 if documentation is not specific about sepsis
Coding Notes
- Ensure documentation specifies 'candidal sepsis' to avoid using unspecified codes.
B37.89 - Other forms of candidiasis
Use when specific Candida species are identified in lab results.
Applicable To
- Specific Candida species identification
Excludes
- Candidal sepsis (B37.7)
Clinical Validation Requirements
- PCR or culture results identifying specific Candida species
Coding Notes
Use in conjunction with B37.7 when species are identified.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Infection due to central venous catheter
T80.211ADifferential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Candidiasis, unspecified
B37.9Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Candidemia to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code B37.7.
Impact
Clinical: May lead to under-treatment of sepsis., Regulatory: Non-compliance with coding specificity requirements., Financial: Potential loss of MCC-related reimbursement.
Mitigation Strategy
Educate on the importance of specifying sepsis, Implement documentation checks
Impact
Reimbursement: Lower reimbursement due to lack of MCC status., Compliance: Non-compliance with coding guidelines for specificity., Data Quality: Inaccurate data representation of patient conditions.
Mitigation Strategy
Ensure documentation specifies 'candidal sepsis' to use B37.7.
Impact
Failure to document 'candidal sepsis' can lead to audits.
Mitigation Strategy
Regular training on documentation specificity.
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 Candidemia, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Candidemia
Use these documentation templates to ensure complete and accurate documentation for Candidemia. These templates include all required elements for proper coding and billing.
Candidemia with central line infection
Specialty: Infectious DiseaseRequired Elements
- Blood culture results
- Systemic symptoms
- Central line presence and removal
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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