ICD-10 Coding for Oral Thrush(B37.0, B37.9)
Complete ICD-10-CM coding and documentation guide for Oral Thrush. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Oral Thrush
B37.0-B37.9Primary Range
Candidiasis
This range includes codes for candidiasis, with B37.0 specifically for oral thrush.
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 clinical or laboratory evidence. |
|
| B37.9 | Candidiasis, unspecified | Use when candidiasis is diagnosed but the specific site is not documented. |
|
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 oral thrush
Essential facts and insights about Oral Thrush
Primary ICD-10-CM Codes for oral thrush
Decision Criteria
clinical Criteria
- Presence of white plaques confirmed by KOH prep.
coding Criteria
- Sequence underlying conditions before B37.0.
Applicable To
- Oral thrush
- Candidal infection of the mouth
Excludes
- Esophageal candidiasis (B37.81)
Clinical Validation Requirements
- White, curd-like plaques on buccal mucosa/tongue unremovable by scraping
- Confirmed by KOH prep/fungal culture
Code-Specific Risks
- Incorrectly coding as unspecified candidiasis (B37.9) when oral site is confirmed.
Coding Notes
- Ensure documentation specifies lesion location and diagnostic method.
B37.9 - Candidiasis, unspecified
Use when candidiasis is diagnosed but the specific site is not documented.
Excludes
- Specific sites of candidiasis (e.g., B37.0 for oral)
Clinical Validation Requirements
- General symptoms of candidiasis without specific site documentation.
Coding Notes
Avoid use if specific site is documented.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Long-term (current) use of antibiotics
Z79.3Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Oral Thrush 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 miss critical health information., Regulatory: Non-compliance with coding guidelines., Financial: Potential loss of reimbursement.
Mitigation Strategy
Review patient's medical history for systemic conditions., Ensure thorough documentation of all relevant health issues.
Impact
Reimbursement: May lead to incorrect DRG assignment., Compliance: Increases risk of audit due to lack of specificity., Data Quality: Decreases accuracy of clinical data.
Mitigation Strategy
Use B37.0 when oral candidiasis is documented.
Impact
Using unspecified codes when specific sites are documented.
Mitigation Strategy
Ensure documentation supports the most specific code available.
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 Oral Thrush, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Oral Thrush
Use these documentation templates to ensure complete and accurate documentation for Oral Thrush. These templates include all required elements for proper coding and billing.
Primary Care Visit for Oral Thrush
Specialty: Primary CareRequired Elements
- Chief complaint
- Physical exam findings
- Diagnostic tests
- Associated conditions
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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