B45.0

Billable

Pulmonary cryptococcosis

HCC Category Mapping

V28HCC 6 — Opportunistic Infections

0.439

V24HCC 6 — Opportunistic Infections

0.440

ESRDHCC 6 — Opportunistic Infections

0.000

RxHCCHCC 5 — Opportunistic Infections

0.000

What This Code Means

A fungal infection of the lungs caused by Cryptococcus, a yeast-like fungus that typically affects immunocompromised individuals.

Coding Tips

•Cryptococcal meningitis is common in HIV patients; check for CNS involvement and code separately if present
•Document CD4 count or immunocompromised status, as this significantly impacts treatment decisions

Clinical Significance

Pulmonary cryptococcosis is an opportunistic fungal infection caused by Cryptococcus neoformans that primarily affects immunocompromised patients, especially those with HIV/AIDS with CD4 counts below 100. It can be the presenting manifestation of undiagnosed HIV and should always prompt evaluation for underlying immune deficiency.

Documentation Requirements

✓Positive cryptococcal antigen (serum or bronchoalveolar lavage) or culture confirmation
✓Chest imaging findings: nodules, cavitary lesions, diffuse infiltrates, or mass-like consolidation
✓Documented immunocompromised state: HIV status with CD4 count, transplant, immunosuppressive therapy
✓Respiratory symptoms: cough, dyspnea, chest pain
✓Assessment for concurrent cryptococcal meningitis (lumbar puncture results if performed)

Commonly Confused Codes

B45.1 (Cerebral cryptococcosis) - central nervous system involvement requires B45.1; pulmonary and cerebral can be coded together if both are present B45.7 (Disseminated cryptococcosis) - use when infection has spread to multiple organ systems J18.9 (Pneumonia, unspecified) - cryptococcal pneumonia must be coded specifically, not as unspecified pneumonia

Code Hierarchy

└B45Cryptococcosis └B45.0Pulmonary cryptococcosis

└B45.0Pulmonary cryptococcosis