B39.2 ICD-10-CM Code: Pulmonary histoplasmosis capsulati, unspecified
B39.2 is not a CMS-HCC payment code. MEAT criteria · RAF calculator · HCC Buddy coding tools
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FY 2026 Apr update / Certain infectious and parasitic diseases (A00-B99) / Mycoses (B35-B49)
B39.2
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidancePulmonary histoplasmosis capsulati, unspecified
A fungal lung infection caused by Histoplasma capsulatum where it is unclear whether the infection developed suddenly or gradually.
Buddy Insight
Pulmonary histoplasmosis capsulati, unspecified, captures confirmed pulmonary histoplasmosis when chronicity cannot be determined.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
MappedHCC 115
RAF 0.130
ACA/HHS
MappedHCC 163
Varies by metal level
ESRD/PACE
MappedHCC 115
RAF 0.030
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for B39.2 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for B39.2 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for B39.2 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for B39.2 in this effective period.
Code First
Official- associated AIDS (B20)
Use Additional
Official- code for any associated manifestations, such as:
- endocarditis (I39)
- meningitis (G02)
- pericarditis (I32)
- retinitis (H32)
Code Also
OfficialICD-10-CM does not list Code Also instructions for B39.2 in this effective period.
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
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 B39.2 an HCC code?
Yes. B39.2 maps to Pneumococcal Pneumonia, Empyema, Lung Abscess under the V24 model but is not retained in V28.
- Code
- B39.2
- Description
- Pulmonary histoplasmosis capsulati, unspecified
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF
- —
- Billable
- Yes
- Payment year
- 2026
HCC Category Mapping
Each model's RAF is its CMS base weight for that model's standard population, so weights are not directly comparable across models: CMS-HCC V28 and V24 use Community, Non-Dual, Aged; ESRD uses the dialysis continuing-enrollee model; RxHCC is the Part D continuing-enrollee, non-low-income, aged weight (a larger scale than CMS-HCC). ACA/HHS has no single weight — it varies by metal level. Actual per-patient RAF contribution depends on member segment, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains in use during the transition and for historical data.
Work B39.2 in the Code Book — tabular path, V28 RAF, and MEAT checklist →
MEAT Criteria for B39.2
For B39.2 to count as a valid HCC diagnosis in a given encounter, the provider's documentation must show MEAT: Monitor, Evaluate, Assess, or Treat. A diagnosis from a prior year does not carry forward automatically, it has to be re-documented and supported each calendar year.
- MMonitor: signs, symptoms, disease progression, or lab trending documented in the note
- EEvaluate: test results, medication response, or physical findings reviewed by the provider
- AAssess: explicit mention in the assessment or plan with acknowledgment of status
- TTreat: medication, referral, procedure, therapy, or counseling tied to the diagnosis
Only one of M/E/A/T is required to support the code, but the documentation must be specific enough to show that the provider actually addressed B39.2 during that encounter, not just copy-forwarded from a problem list.
Coder workflow notes
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What This Code Means
B39.2 is the ICD-10-CM diagnosis code for pulmonary histoplasmosis capsulati, unspecified. A fungal lung infection caused by Histoplasma capsulatum where it is unclear whether the infection developed suddenly or gradually. B39.2 sits in the ICD-10-CM chapter for certain infectious and parasitic diseases (a00-b99), within the section covering mycoses (b35-b49).
Under the older CMS-HCC V24 model, B39.2 maps to Pneumococcal Pneumonia, Empyema, Lung Abscess (HCC 115) with a community, non-dual, aged base RAF weight of 0.130. V28 is the CMS-HCC risk adjustment model that reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition.
Use this code only when the provider has not specified acute versus chronic course. Because B39.2 maps to a payment HCC, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's Medicare Advantage risk adjustment score. When documentation is ambiguous, coders should issue a provider query rather than assume the highest-specificity variant.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for B39.2 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Use this code only when the provider has not specified acute versus chronic course
- •Query the provider if clinical documentation suggests either acute or chronic presentation
Clinical Significance
Pulmonary histoplasmosis capsulati, unspecified, captures confirmed pulmonary histoplasmosis when chronicity cannot be determined. This code should prompt a provider query, as distinguishing acute from chronic affects treatment decisions and clinical documentation quality measures.
Documentation Requirements
- ✓Confirmed Histoplasma capsulatum diagnosis via serology, antigen, or culture
- ✓Pulmonary involvement documented through imaging or respiratory symptoms
- ✓Provider query initiated and documented regarding acute versus chronic presentation
- ✓Treatment plan consistent with histoplasmosis management
- ✓Relevant exposure history or endemic area residence
Commonly Confused Codes
- •B39.0 (Acute pulmonary histoplasmosis) - use if clinical timeline supports acute presentation
- •B39.1 (Chronic pulmonary histoplasmosis) - use if progressive cavitary disease is documented
- •B39.4 (Histoplasmosis capsulati, unspecified) - even less specific, as it does not specify pulmonary involvement