B37.5 ICD-10-CM Code: Candidal meningitis
B37.5 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · HCC coding software
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FY 2026 Apr update / Certain infectious and parasitic diseases (A00-B99) / Mycoses (B35-B49)
B37.5
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceCandidal meningitis
A serious yeast infection of the membrane surrounding the brain and spinal cord, causing inflammation and potentially life-threatening complications.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
HistoricalHistorical
Not used for CY2026 payment
ACA/HHS
MappedHCC 003
Code-level coefficient reference
ESRD/PACE
N/A—
Not mapped
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for B37.5 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for B37.5 in this effective period.
Related Child Codes
Includes
Official- candidosis
- moniliasis
Excludes 1
Official- neonatal candidiasis (P37.5)
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for B37.5 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for B37.5 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for B37.5 in this effective period.
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 B37.5 an HCC code?
B37.5 is not in the CMS-HCC V28 or V24 community payment model. B37.5 also appears in the HHS-HCC commercial risk model (HCC 003 (HHS-HCC 003 adult, RAF varies by metal level)), which is a commercial market model rather than a Medicare Advantage payment mapping.
- Code
- B37.5
- Description
- Candidal meningitis
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF reference coefficient
- —
- Billable
- Yes
- Payment year
- 2026
Coder workflow notes
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This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
B37.5 is the ICD-10-CM diagnosis code for candidal meningitis. A serious yeast infection of the membrane surrounding the brain and spinal cord, causing inflammation and potentially life-threatening complications. B37.5 sits in the ICD-10-CM chapter for certain infectious and parasitic diseases (a00-b99), within the section covering mycoses (b35-b49).
B37.5 has no mapping under the CMS-HCC V28 or V24 community payment models. B37.5 also appears in the HHS-HCC commercial risk model (HCC 003 (HHS-HCC 003 adult, RAF varies by metal level)), which is a commercial market model rather than a Medicare Advantage payment mapping. Do not assign V28 risk adjustment value from this page; verify the applicable model and payment year before using this code for risk adjustment.
This is a serious condition typically seen in immunocompromised patients; ensure documentation supports CNS involvement.
HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for B37.5 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This is a serious condition typically seen in immunocompromised patients; ensure documentation supports CNS involvement
- •Verify that lumbar puncture or imaging findings confirm meningitis before coding this diagnosis