B37.7

Billable

Candidal sepsis

HCC Category Mapping

RxHCCHCC 5 — Opportunistic Infections

0.000

What This Code Means

A life-threatening bloodstream infection caused by Candida yeast that spreads throughout the body.

Coding Tips

•This is a critical condition requiring blood culture confirmation; verify positive candidal blood cultures in documentation
•Typically requires ICU-level care and systemic antifungal therapy; ensure severity of illness is reflected in coding

Clinical Significance

Candidal sepsis (candidemia) is a life-threatening bloodstream infection caused by Candida species, most commonly occurring in hospitalized patients with central venous catheters, prolonged antibiotic use, or immunosuppression. It carries 30-50% mortality and requires immediate systemic antifungal therapy and source control (often catheter removal).

Documentation Requirements

✓Positive blood culture for Candida species (candidemia confirmed)
✓Species identification and antifungal susceptibility testing documented
✓Source of candidemia investigated: central line, GI tract, genitourinary source
✓SIRS/sepsis criteria met with organ dysfunction assessment
✓Treatment: antifungal agent, central line removal if catheter-associated, ophthalmologic exam for Candida endophthalmitis screening

Commonly Confused Codes

A41.9 (Sepsis, unspecified organism) — Generic sepsis; use B37.7 when Candida is the confirmed organism from blood cultures B37.1 (Pulmonary candidiasis) — Lung-specific infection; candidemia is bloodstream infection that may or may not involve lungs B37.49 (Other urogenital candidiasis) — Localized Candida infection; sepsis indicates bloodstream spread B49 (Unspecified mycosis) — Nonspecific fungal infection; B37.7 provides organism and site specificity

Code Hierarchy

└B37Candidiasis └B37.7Candidal sepsis

└B37.7Candidal sepsis