ICD-10 Coding for Thrush(B37.0, B37.3, B37.81, B37.9)
Complete ICD-10-CM coding and documentation guide for Thrush. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Thrush
B37-B37.9Primary Range
Candidiasis
This range includes all forms of candidiasis, including oral, esophageal, and vulvovaginal 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 | Candidiasis of mouth | Use for confirmed oral thrush with clinical validation. |
|
| B37.3 | Candidiasis of vulva and vagina | Use for confirmed vulvovaginal candidiasis with clinical validation. |
|
| B37.81 | Candidal esophagitis | Use for confirmed esophageal candidiasis with endoscopic validation. |
|
| B37.9 | Candidiasis, unspecified | Use only when specific location or lab confirmation is unavailable. |
|
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 Thrush
Primary ICD-10-CM Codes for thrush
Decision Criteria
clinical Criteria
- Presence of white plaques and positive KOH test
Applicable To
- Oral thrush
Excludes
- Angular cheilitis (B37.83)
Clinical Validation Requirements
- Presence of creamy white plaques on the tongue or buccal mucosa
- Positive KOH preparation
Code-Specific Risks
- Avoid using without specific clinical findings.
Coding Notes
- Ensure documentation specifies location and clinical findings.
B37.3 - Candidiasis of vulva and vagina
Use for confirmed vulvovaginal candidiasis with clinical validation.
Applicable To
- Vulvovaginal thrush
Excludes
- Bacterial vaginosis (N76.0)
Clinical Validation Requirements
- Thick white discharge with pruritus
- Vaginal pH <4.5
Coding Notes
Ensure documentation specifies symptoms and test results.
B37.81 - Candidal esophagitis
Use for confirmed esophageal candidiasis with endoscopic validation.
Applicable To
- Esophageal thrush
Excludes
- Esophageal ulcer (K22.1)
Clinical Validation Requirements
- Odynophagia with endoscopic confirmation of whitish plaques
Coding Notes
Ensure documentation includes endoscopic findings.
B37.9 - Candidiasis, unspecified
Use only when specific location or lab confirmation is unavailable.
Clinical Validation Requirements
- Clinical diagnosis without specific location or lab confirmation
Coding Notes
Use as a last resort when specific details are unavailable.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
HIV disease
B20Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting 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: Leads to misdiagnosis or inappropriate treatment., Regulatory: Non-compliance with documentation standards., Financial: Potential for denied claims or reduced reimbursement.
Mitigation Strategy
Use specific clinical terms., Document test results and symptoms clearly.
Impact
Reimbursement: May lead to lower reimbursement rates., Compliance: Could result in non-compliance with coding guidelines., Data Quality: Reduces the specificity and quality of health data.
Mitigation Strategy
Ensure documentation supports the use of specific codes like B37.0 or B37.3.
Impact
Reimbursement: Incorrect sequencing can affect DRG assignment., Compliance: Violates sequencing rules in ICD-10., Data Quality: Impacts the accuracy of patient records.
Mitigation Strategy
Sequence underlying conditions like HIV (B20) before thrush codes.
Impact
Failure to code underlying conditions first.
Mitigation Strategy
Educate coders on proper sequencing rules.
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 Thrush, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Thrush
Use these documentation templates to ensure complete and accurate documentation for Thrush. These templates include all required elements for proper coding and billing.
Oral Thrush in HIV Patient
Specialty: Infectious DiseaseRequired Elements
- Patient demographics
- Clinical symptoms
- Lab test results
- Underlying conditions
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Need help with ICD-10 coding for Thrush? Ask your questions below.