B42.89 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · HCC Buddy coding tools

ICD-10-CM Code View

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Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.

Code lookupB42.89

Effective periodFY2026 Apr Update (Apr 1-Sep 30)

FY 2026 Apr update / Certain infectious and parasitic diseases (A00-B99) / Mycoses (B35-B49)

B42.89

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Other forms of sporotrichosis

Sporotrichosis is a fungal infection caused by the Sporothrix fungus, typically acquired through minor skin injuries from contaminated plant material or soil. This code represents less common forms of the infection beyond the typical skin manifestations.

Overview Risk Models Code Book Documentation Audit Notes Edition comparison

CMS-HCC V28

N/A

—

Not risk-adjusted for this model/period.

Not mapped

CMS-HCC V24

Historical

Not used for standard CY2026 Medicare Advantage payment. Select a historical period to review V24.

Not used for CY2026 payment

ACA/HHS

N/A

—

Not risk-adjusted for this model/period.

Not mapped

ESRD/PACE

N/A

—

Not risk-adjusted for this model/period.

Not mapped

RXHCC

N/A

—

Not risk-adjusted for this model/period.

Not mapped

Code Book Path

Official

B42Sporotrichosis B42.8Other forms of sporotrichosis B42.89Other forms of sporotrichosis

Inclusion Terms

Official

No inclusion terms are included in this display for B42.89. Check the code and parent instructions in the Code Book.

Excludes 2

Official

carrier or suspected carrier of infectious disease (Z22.-)Inherited from A00-B99, B35-B49
infectious and parasitic diseases complicating pregnancy, childbirth and the puerperium (O98.-)Inherited from A00-B99, B35-B49
infectious and parasitic diseases specific to the perinatal period (P35-P39)Inherited from A00-B99, B35-B49
influenza and other acute respiratory infections (J00-J22)Inherited from A00-B99, B35-B49
hypersensitivity pneumonitis due to organic dust (J67.-)Inherited from A00-B99, B35-B49
mycosis fungoides (C84.0-)Inherited from A00-B99, B35-B49

Related Codes

Official

B42.81Cerebral sporotrichosis B42.82Sporotrichosis arthritis

Includes

Official

diseases generally recognized as communicable or transmissibleInherited from A00-B99

Excludes 1

Official

certain localized infections - see body system-related chaptersInherited from A00-B99

Code First

Official

No Code First sequencing instructions are included in this display for B42.89. Check the code and parent instructions in the Code Book.

Use Additional

Official

code to identify resistance to antimicrobial drugs (Z16.-)Inherited from A00-B99

Code Also

Official

No Code Also instructions are included in this display for B42.89. Check the code and parent instructions in the Code Book.

Buddy Documentation Tip

HCC Buddy guidance

Verify the specific form of sporotrichosis documented (pulmonary, osteoarticular, or disseminated) as more specific codes (B42.0-B42.82) may be more appropriate than the 'other forms' code

Document the route of exposure or affected body system when available, as this helps justify the use of this less common category and supports medical necessity

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 B42.89 an HCC code?

No. B42.89 is a billable ICD-10-CM code with no mapping under the current CMS-HCC V28 community payment model, and none under the ESRD, Part D RxHCC, or HHS-HCC models.

Code: B42.89
Description: Other forms of sporotrichosis
HCC (V28): No CMS-HCC V28 mapping
RAF reference coefficient: —
Billable: Yes
Payment year: 2026

Coder workflow notes

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What This Code Means

B42.89 is the ICD-10-CM diagnosis code for other forms of sporotrichosis. Sporotrichosis is a fungal infection caused by the Sporothrix fungus, typically acquired through minor skin injuries from contaminated plant material or soil. This code represents less common forms of the infection beyond the typical skin manifestations. B42.89 sits in the ICD-10-CM chapter for certain infectious and parasitic diseases (a00-b99), within the section covering mycoses (b35-b49).

B42.89 is a billable ICD-10-CM code, but no current CMS-HCC V28 community payment mapping is shown, and none under the ESRD, Part D RxHCC, or HHS-HCC models. Do not assign risk adjustment value from this page when no source-backed mapping is shown; verify the applicable model and payment year.

Verify the specific form of sporotrichosis documented (pulmonary, osteoarticular, or disseminated) as more specific codes (B42.0-B42.82) may be more appropriate than the 'other forms' code.

HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for B42.89 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Verify the specific form of sporotrichosis documented (pulmonary, osteoarticular, or disseminated) as more specific codes (B42.0-B42.82) may be more appropriate than the 'other forms' code
•Document the route of exposure or affected body system when available, as this helps justify the use of this less common category and supports medical necessity