ICD-10 Coding for Fungal Infection(B35.1, B37.0)
Complete ICD-10-CM coding and documentation guide for Fungal Infection. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Fungal Infection
B35-B49Primary Range
Mycoses
This range includes all fungal infections, covering various types and sites of infection.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| B35.1 | Onychomycosis | Use when there is confirmed fungal infection of the nail. |
|
| B37.0 | Candidal stomatitis | Use when there is confirmed candidal infection in the oral cavity. |
|
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 onychomycosis
Essential facts and insights about Fungal Infection
Primary ICD-10-CM Codes for fungal infection
Decision Criteria
clinical Criteria
- Presence of subungual debris and positive fungal culture
Applicable To
- Fungal infection of the nail
Excludes
- Nail psoriasis (L40.9)
Clinical Validation Requirements
- KOH preparation positive for hyphae
- Culture confirming dermatophyte
Code-Specific Risks
- Misuse of unspecified codes leading to denials
Coding Notes
- Ensure documentation specifies the fungal organism and site.
B37.0 - Candidal stomatitis
Use when there is confirmed candidal infection in the oral cavity.
Applicable To
- Thrush
Excludes
- Oral hairy leukoplakia (K13.3)
Clinical Validation Requirements
- White plaques on tongue/mucosa
- Positive fungal culture
Coding Notes
Document specific symptoms and positive culture results.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Fungal Infection to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code B35.1.
Impact
Clinical: Inaccurate treatment plans, Regulatory: Non-compliance with coding standards, Financial: Potential reimbursement denials
Mitigation Strategy
Ensure lab results are included in documentation, Use specific codes when organism is known
Impact
Reimbursement: Denials due to lack of specificity, Compliance: Non-compliance with ICD-10 guidelines, Data Quality: Poor data quality affecting clinical decision-making
Mitigation Strategy
Ensure documentation supports the use of specific codes like B35.1 instead of B35.9.
Impact
High risk of audit if unspecified codes are used without justification
Mitigation Strategy
Ensure documentation supports the use of specific codes.
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 Fungal Infection, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Fungal Infection
Use these documentation templates to ensure complete and accurate documentation for Fungal Infection. These templates include all required elements for proper coding and billing.
Chronic fungal nail infection
Specialty: DermatologyRequired Elements
- Patient history
- Physical examination findings
- Laboratory test results
- Diagnosis
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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