B44.0
BillableInvasive pulmonary aspergillosis
HCC Category Mapping
V28HCC 6 — Opportunistic Infections
0.439V24HCC 6 — Opportunistic Infections
0.440ESRDHCC 6 — Opportunistic Infections
0.000RxHCCHCC 5 — Opportunistic Infections
0.000What This Code Means
A serious fungal infection of the lungs caused by Aspergillus fungus that invades lung tissue, typically occurring in immunocompromised patients.
Coding Tips
- •Document the extent of pulmonary involvement and whether this is acute or chronic invasive aspergillosis
- •Verify patient's immunocompromised status (HIV, transplant, chemotherapy, etc.) as this is critical for clinical context
Clinical Significance
Invasive pulmonary aspergillosis is a life-threatening opportunistic infection with mortality rates of 30-95% depending on immune status and treatment timing. It primarily affects severely immunocompromised patients including those on chemotherapy, post-transplant immunosuppression, or with prolonged neutropenia. This code carries significant RAF weight reflecting the extreme clinical acuity.
Documentation Requirements
- ✓CT imaging with halo sign or air-crescent sign characteristic of invasive aspergillosis
- ✓Positive galactomannan antigen (serum or bronchoalveolar lavage) or culture/histopathology
- ✓Documented immunocompromised state: neutropenia, transplant, high-dose steroids, chemotherapy
- ✓Severity indicators: degree and duration of neutropenia, ICU admission, mechanical ventilation
- ✓Antifungal treatment documented (voriconazole as first-line, or amphotericin B)
Commonly Confused Codes
B44.1 (Other pulmonary aspergillosis) - non-invasive forms including aspergilloma (fungus ball); invasive form penetrates lung tissueB44.81 (Allergic bronchopulmonary aspergillosis) - an allergic response, NOT invasive infection; completely different pathophysiology and HCC mappingB44.9 (Aspergillosis, unspecified) - never use when invasive disease is documented; significant RAF impact difference