ICD-10 Coding for Candidiasis(B37.0, B37.3, B37.7, B37.9)
Complete ICD-10-CM coding and documentation guide for Candidiasis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Candidiasis
B37Primary Range
Candidiasis
This range includes all forms of candidiasis, specifying different anatomical sites and types of infection caused by Candida species.
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 for oral thrush confirmed by clinical examination and laboratory tests. |
|
| B37.3 | Candidal vulvovaginitis | Use for vulvovaginal candidiasis confirmed by clinical symptoms and lab tests. |
|
| B37.7 | Candidal sepsis | Use when candidemia is confirmed by blood cultures and systemic symptoms are present. |
|
| B37.9 | Candidiasis, unspecified | Use only when the site of candidiasis is not specified in the documentation. |
|
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 candidiasis
Essential facts and insights about Candidiasis
Primary ICD-10-CM Codes for candidiasis
Decision Criteria
clinical Criteria
- Presence of white plaques on oral mucosa with lab confirmation
Applicable To
- Oral thrush
Excludes
- Candidal esophagitis (B37.81)
Clinical Validation Requirements
- White plaques on oral mucosa
- KOH prep or PCR confirmation
Code-Specific Risks
- Misclassification if esophageal involvement is present
Coding Notes
- Ensure documentation specifies oral involvement to avoid using unspecified codes.
B37.3 - Candidal vulvovaginitis
Use for vulvovaginal candidiasis confirmed by clinical symptoms and lab tests.
Applicable To
- Vaginal yeast infection
Excludes
- Bacterial vaginosis (A59)
Clinical Validation Requirements
- Pruritus and thick white discharge
- Microscopy confirmation
Coding Notes
Ensure documentation specifies vulvovaginal involvement to avoid unspecified codes.
B37.7 - Candidal sepsis
Use when candidemia is confirmed by blood cultures and systemic symptoms are present.
Applicable To
- Candidemia
Excludes
- Sepsis due to other organisms
Clinical Validation Requirements
- Blood culture positive for Candida
- Systemic inflammatory response
Coding Notes
Ensure candidemia is confirmed by lab tests to avoid incorrect coding.
B37.9 - Candidiasis, unspecified
Use only when the site of candidiasis is not specified in the documentation.
Applicable To
- Thrush
Excludes
- Specific site candidiasis
Clinical Validation Requirements
- General symptoms without specific site documentation
Coding Notes
Avoid using if specific site information is available.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Candidiasis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code B37.0.
Impact
Clinical: May lead to inappropriate treatment., Regulatory: Non-compliance with documentation standards., Financial: Potential for denied claims or reduced reimbursement.
Mitigation Strategy
Train staff on documentation requirements, Use templates to ensure completeness
Impact
Reimbursement: May lead to lower reimbursement rates., Compliance: Non-compliance with coding guidelines., Data Quality: Decreased accuracy in health records.
Mitigation Strategy
Use specific site codes like B37.0 or B37.3 when documentation specifies the site.
Impact
High risk of audit if unspecified codes are used without justification.
Mitigation Strategy
Ensure documentation supports the use of unspecified codes only when site information is unavailable.
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 Candidiasis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Candidiasis
Use these documentation templates to ensure complete and accurate documentation for Candidiasis. These templates include all required elements for proper coding and billing.
Vulvovaginal Candidiasis
Specialty: GynecologyRequired Elements
- Patient symptoms
- Microscopy results
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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