What is ICD-10 code B45.2?

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. It belongs to the ICD-10-CM chapter for certain infectious and parasitic diseases (a00-b99). B45.2 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. B45.2 is part of the FY2026 ICD-10-CM code set published by the CMS National Center for Health Statistics and used on Medicare, Medicaid, and commercial claims in the United States.

Yes. B45.2 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. B45.2 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

What is the V28 vs V24 difference for B45.2?

CMS phased in the V28 risk adjustment model over payment years 2024 (33%), 2025 (67%), and 2026 (100%), replacing V24. V28 consolidates HCC categories, removes some lower-acuity conditions, and recalibrates RAF weights across the entire model. For B45.2, V28 maps to Opportunistic Infections at RAF 0.381 while V24 mapped to Opportunistic Infections at RAF 0.424. Both models can still appear in legacy data and in payer-specific lookback periods.

What should coders know when reporting B45.2?

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 Because B45.2 maps to a payment HCC, the documentation must also satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's risk adjustment score.

2026 ICD-10-CM B45.2: Cutaneous cryptococcosis

ICD-10-CM Code View

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Code lookupB45.2Effective periodFY2026 Apr Update (Apr 1-Sep 30)

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

B45.2

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

Cutaneous cryptococcosis

A fungal infection of the skin caused by Cryptococcus, which can appear as lesions or sores on the skin surface.

Buddy Insight

Cutaneous cryptococcosis often represents a manifestation of disseminated disease rather than primary skin infection, particularly in immunocompromised patients.

CMS-HCC V28

Mapped

HCC 6

Opportunistic Infections

RAF 0.381

CMS-HCC V24

Mapped

HCC 6

Opportunistic Infections

RAF 0.424

ACA/HHS

Mapped

HCC 6

HHS-HCC 6

Varies by metal level

ESRD/PACE

Mapped

HCC 6

Opportunistic Infections

RAF 0.076

RXHCC

Mapped

HCC 5

Opportunistic Infections

RAF 0.468

Code Book Path

Official

B45Cryptococcosis

B45.2Cutaneous cryptococcosis

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for B45.2 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for B45.2 in this effective period.

Related Child Codes

Official

B45.0Pulmonary cryptococcosis

B45.1Cerebral cryptococcosis

B45.3Osseous cryptococcosis

B45.7Disseminated cryptococcosis

B45.8Other forms of cryptococcosis

Includes

Official

ICD-10-CM does not list Includes notes for B45.2 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for B45.2 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for B45.2 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for B45.2 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for B45.2 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

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

MEAT Support

HCC Buddy guidance

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

Audit Caution

HCC Buddy guidance

Coding only the cutaneous manifestation when workup reveals disseminated disease requiring B45.7

Missing the significance of skin cryptococcosis as a marker for systemic disease — always investigate for deeper organ involvement

Confusing cryptococcal skin lesions with molluscum contagiosum in HIV patients, as they can appear similar

Common Mistakes

HCC Buddy guidance

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

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 B45.2 an HCC code?

Yes. B45.2 (Cutaneous cryptococcosis) maps to Opportunistic Infections under the CMS-HCC V28 risk adjustment model (and Opportunistic Infections under V24), with a community non-dual aged RAF of 0.381. It is billable for payment year 2026.

Coder answer: B45.2 is billable and maps to V28 HCC 6, Opportunistic Infections. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.

Code: B45.2
Description: Cutaneous cryptococcosis
HCC (V28): HCC 6 — Opportunistic Infections
RAF: 0.381
Billable: Yes
Payment year: 2026

HCC Category Mapping

V28HCC 6, Opportunistic Infections

0.381

V24HCC 6, Opportunistic Infections

0.424

ESRDHCC 6, Opportunistic Infections

0.076

RxHCCHCC 5, Opportunistic Infections

0.468

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 B45.2 in the Code Book — tabular path, V28 RAF, and MEAT checklist →

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.

Coder workflow notes

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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 0.381. Under the older V24 model, B45.2 mapped to the same category but with a base RAF weight of 0.424, 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