B39.1
BillableChronic pulmonary histoplasmosis capsulati
HCC Category Mapping
V24HCC 115 — Pneumococcal Pneumonia, Empyema, Lung Abscess
0.339ESRDHCC 115 — Pneumococcal Pneumonia, Empyema, Lung Abscess
0.000What This Code Means
A long-standing fungal lung infection caused by Histoplasma capsulatum that develops slowly over months or years with persistent respiratory symptoms.
Coding Tips
- •Chronic form often mimics tuberculosis or other chronic lung diseases; review imaging and clinical course
- •Ensure documentation clearly indicates chronic progression rather than acute presentation
Clinical Significance
Chronic pulmonary histoplasmosis capsulati is a progressive cavitary lung disease that closely mimics pulmonary tuberculosis. It typically affects patients with underlying structural lung disease such as emphysema. Accurate differentiation from TB and other chronic lung conditions is critical for appropriate treatment and risk coding.
Documentation Requirements
- ✓Documentation of chronic/progressive course (months to years)
- ✓Imaging showing upper lobe cavitary disease, progressive fibrosis, or bullae
- ✓Positive Histoplasma culture, antigen, or complement fixation titers
- ✓Underlying lung disease documented (emphysema, chronic obstructive pulmonary disease)
- ✓Evidence that tuberculosis has been ruled out (negative acid-fast bacilli cultures)
Commonly Confused Codes
B39.0 (Acute pulmonary histoplasmosis capsulati) - acute form has rapid onset; chronic shows progressive cavitary diseaseA15.0 (Tuberculosis of lung) - chronic histoplasmosis mimics TB; microbiologic confirmation differentiatesB39.4 (Histoplasmosis capsulati, unspecified) - avoid when pulmonary site and chronicity are documented
Code Hierarchy
└B39Histoplasmosis└B39.1Chronic pulmonary histoplasmosis capsulati
└B39.1Chronic pulmonary histoplasmosis capsulati