B37.42 ICD-10-CM Code: Candidal balanitis
B37.42 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · free HCC coding tools
HCC Buddy Code Card
Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.
FY 2026 Apr update / Certain infectious and parasitic diseases (A00-B99) / Mycoses (B35-B49)
B37.42
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceCandidal balanitis
A yeast infection of the head of the penis in males, causing inflammation, redness, and itching.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
HistoricalHistorical
Not used for CY2026 payment
ACA/HHS
N/A—
Not mapped
ESRD/PACE
N/A—
Not mapped
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
OfficialNo inclusion terms are included in this display for B37.42. Check the code and parent instructions in the Code Book.
Excludes 2
Official- carrier or suspected carrier of infectious disease (Z22.-)Inherited from A00-B99, B35-B49
- infectious and parasitic diseases complicating pregnancy, childbirth and the puerperium (O98.-)Inherited from A00-B99, B35-B49
- infectious and parasitic diseases specific to the perinatal period (P35-P39)Inherited from A00-B99, B35-B49
- influenza and other acute respiratory infections (J00-J22)Inherited from A00-B99, B35-B49
- hypersensitivity pneumonitis due to organic dust (J67.-)Inherited from A00-B99, B35-B49
- mycosis fungoides (C84.0-)Inherited from A00-B99, B35-B49
Related Codes
Includes
Official- diseases generally recognized as communicable or transmissibleInherited from A00-B99, B37
- candidosisInherited from A00-B99, B37
- moniliasisInherited from A00-B99, B37
Excludes 1
Official- certain localized infections - see body system-related chaptersInherited from A00-B99, B37
- neonatal candidiasis (P37.5)Inherited from A00-B99, B37
Code First
OfficialNo Code First sequencing instructions are included in this display for B37.42. Check the code and parent instructions in the Code Book.
Use Additional
Official- code to identify resistance to antimicrobial drugs (Z16.-)Inherited from A00-B99
Code Also
OfficialNo Code Also instructions are included in this display for B37.42. Check the code and parent instructions in the Code Book.
Buddy Documentation Tip
Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →
Is B37.42 an HCC code?
No. B37.42 is a billable ICD-10-CM code with no mapping under the current CMS-HCC V28 community payment model, and none under the ESRD, Part D RxHCC, or HHS-HCC models.
- Code
- B37.42
- Description
- Candidal balanitis
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF reference coefficient
- —
- Billable
- Yes
- Payment year
- 2026
Coder workflow notes
Get the V28 mapping + MEAT cheat sheet
One printable reference: check representative V28 mappings and the documentation reminders your note needs. Free, no card.
Free PDF. No card. Unsubscribe anytime.
What This Code Means
B37.42 is the ICD-10-CM diagnosis code for candidal balanitis. A yeast infection of the head of the penis in males, causing inflammation, redness, and itching. B37.42 sits in the ICD-10-CM chapter for certain infectious and parasitic diseases (a00-b99), within the section covering mycoses (b35-b49).
B37.42 is a billable ICD-10-CM code, but no current CMS-HCC V28 community payment mapping is shown, and none under the ESRD, Part D RxHCC, or HHS-HCC models. Do not assign risk adjustment value from this page when no source-backed mapping is shown; verify the applicable model and payment year.
This code is specific to males; ensure proper gender documentation in the medical record.
HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for B37.42 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This code is specific to males; ensure proper gender documentation in the medical record
- •Often associated with poor hygiene, diabetes, or sexual transmission from a partner with candidal vulvovaginitis