B39.0

Billable

Acute pulmonary histoplasmosis capsulati

HCC Category Mapping

V24HCC 115 — Pneumococcal Pneumonia, Empyema, Lung Abscess

0.339

ESRDHCC 115 — Pneumococcal Pneumonia, Empyema, Lung Abscess

0.000

What This Code Means

A fungal lung infection caused by Histoplasma capsulatum that develops suddenly with acute symptoms like fever, cough, and chest discomfort.

Coding Tips

•Acute presentation typically occurs within weeks of exposure to contaminated soil or bird/bat droppings
•Document whether respiratory symptoms are present to support acute classification

Clinical Significance

Acute pulmonary histoplasmosis capsulati represents a significant endemic mycosis in the Ohio and Mississippi River valleys. The acute form indicates recent exposure and active infection requiring distinct management from chronic disease. Accurate coding differentiates resource needs between acute self-limited disease and severe progressive infection requiring hospitalization.

Documentation Requirements

✓Positive Histoplasma antigen (urine or serum) or culture confirmation
✓Acute onset of respiratory symptoms: fever, cough, malaise, chest pain
✓Chest imaging showing diffuse infiltrates, hilar lymphadenopathy, or miliary pattern
✓Exposure history (cave exploration, bird roosts, construction sites in endemic areas)
✓Timeline establishing acute presentation versus chronic disease

Commonly Confused Codes

B39.1 (Chronic pulmonary histoplasmosis capsulati) - chronic form shows cavitation and fibrosis; acute form shows infiltrates and adenopathy B39.2 (Pulmonary histoplasmosis capsulati, unspecified) - use only when acute vs chronic cannot be determined J18.9 (Pneumonia, unspecified) - histoplasmosis should be coded specifically when identified, not as generic pneumonia

Code Hierarchy

└B39Histoplasmosis └B39.0Acute pulmonary histoplasmosis capsulati

└B39.0Acute pulmonary histoplasmosis capsulati