B45.2
BillableCutaneous cryptococcosis
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is B45.2 an HCC code?
Yes. B45.2 maps to Opportunistic Infections under the CMS-HCC V28 risk adjustment model (and Opportunistic Infections under V24).
HCC Category Mapping
RAF weights shown are the community, non-dual, aged base weights from the CMS risk adjustment model file. 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.
MEAT Criteria for B45.2
For B45.2 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 B45.2 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
B45.2 is the ICD-10-CM diagnosis code for cutaneous cryptococcosis. A fungal infection of the skin caused by Cryptococcus, which can appear as lesions or sores on the skin surface. B45.2 sits in the ICD-10-CM chapter for certain infectious and parasitic diseases (a00-b99), within the section covering mycoses (b35-b49).
Under the CMS-HCC V28 risk adjustment model, B45.2 maps to Opportunistic Infections (HCC 6) with a community, non-dual, aged base RAF weight of 0.439. Under the older V24 model, B45.2 mapped to the same category but with a base RAF weight of 0.440 — V28 recalibrated weights across the entire model. 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.
Cutaneous cryptococcosis is often a sign of disseminated disease; review clinical notes for evidence of systemic infection. Because B45.2 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 B45.2 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Cutaneous cryptococcosis is often a sign of disseminated disease; review clinical notes for evidence of systemic infection
- •Document the location and extent of skin involvement for complete clinical picture
Clinical Significance
Cutaneous cryptococcosis often represents a manifestation of disseminated disease rather than primary skin infection, particularly in immunocompromised patients. Skin lesions may be the first clinical presentation of systemic cryptococcosis, making recognition critical for timely diagnosis of potentially life-threatening disseminated infection.
Documentation Requirements
- ✓Skin biopsy with culture or histopathology confirming Cryptococcus
- ✓Description of skin lesions: papules, nodules, ulcers, cellulitis-like lesions, molluscum-like lesions
- ✓Location and extent of cutaneous involvement documented
- ✓Workup for disseminated disease: serum cryptococcal antigen, lumbar puncture, blood cultures
- ✓Immunocompromised status documented
Commonly Confused Codes
- •B45.7 (Disseminated cryptococcosis) - if skin lesions are part of widespread disease, use disseminated code
- •B45.8 (Other forms of cryptococcosis) - use for non-skin, non-lung, non-CNS, non-bone sites
- •L08.9 (Local infection of skin and subcutaneous tissue, unspecified) - do not use for cryptococcal skin infection