ICD-10 Coding for Candidiasis of Mouth(B37.0, B37.83)
Complete ICD-10-CM coding and documentation guide for Candidiasis of Mouth. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Candidiasis of Mouth
B37.0-B37.9Primary Range
Candidiasis
This range includes all forms of candidiasis, with B37.0 specifically for oral candidiasis.
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 | Candidiasis of mouth | Use when oral candidiasis is confirmed by clinical findings and/or lab tests. |
|
| B37.83 | Candidal cheilitis | Use when Candida infection is confirmed at the lip commissures. |
|
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 of mouth
Essential facts and insights about Candidiasis of Mouth
Primary ICD-10-CM Codes for candidiasis of mouth
Decision Criteria
clinical Criteria
- Presence of white plaques and positive lab tests
coding Criteria
- Specific site documentation
Applicable To
- Oral thrush
- Fungal infection of the mouth
Clinical Validation Requirements
- White plaques on tongue or buccal mucosa
- Positive KOH prep or culture for Candida
Code-Specific Risks
- Using B37.9 when specific site is documented
Coding Notes
- Ensure documentation specifies the site and confirms with lab tests to avoid unspecified coding.
B37.83 - Candidal cheilitis
Use when Candida infection is confirmed at the lip commissures.
Applicable To
- Angular cheilitis due to Candida
Excludes
- Oral candidiasis (B37.0)
Clinical Validation Requirements
- Erythema and fissures at the corners of the mouth
- Positive culture for Candida
Coding Notes
Ensure documentation specifies lip involvement and confirms with lab tests.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Candidal esophagitis
B37.81Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Candidiasis of Mouth 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 misdiagnosis., Regulatory: Increases audit risk., Financial: Potential for claim denials.
Mitigation Strategy
Always confirm with lab tests, Document test results in patient record
Impact
Reimbursement: May lead to lower reimbursement due to unspecified coding., Compliance: Increases risk of audits for unspecified codes., Data Quality: Reduces accuracy of clinical data.
Mitigation Strategy
Use specific codes like B37.0 or B37.83 when the site is documented.
Impact
Using unspecified codes when specific sites are documented.
Mitigation Strategy
Ensure documentation specifies the site and confirms with lab tests.
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 of Mouth, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Candidiasis of Mouth
Use these documentation templates to ensure complete and accurate documentation for Candidiasis of Mouth. These templates include all required elements for proper coding and billing.
Oral candidiasis in immunocompromised patient
Specialty: Infectious DiseaseRequired Elements
- Clinical findings
- Lab test results
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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