B45.3
BillableOsseous cryptococcosis
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 fungal infection of the bones caused by Cryptococcus, which can cause bone pain and structural damage.
Coding Tips
- •This is a rare manifestation of cryptococcosis; ensure documentation clearly indicates bone/osseous involvement
- •Investigate for disseminated disease and immunocompromised status, as osseous involvement suggests systemic infection
Clinical Significance
Osseous cryptococcosis is a rare manifestation of disseminated Cryptococcus infection involving bone, typically presenting with lytic lesions that can mimic metastatic disease or primary bone tumors. Its presence strongly suggests systemic dissemination and warrants thorough evaluation for central nervous system and pulmonary involvement.
Documentation Requirements
- ✓Bone biopsy with culture or histopathology confirming Cryptococcus
- ✓Imaging showing lytic bone lesions (radiograph, CT, or MRI)
- ✓Specific bone(s) affected documented with laterality
- ✓Evaluation for disseminated disease documented (serum antigen, lumbar puncture, chest imaging)
- ✓Immunocompromised status documented
Commonly Confused Codes
B45.7 (Disseminated cryptococcosis) - if bone involvement is part of multi-organ disease, consider using the disseminated codeM86.9 (Osteomyelitis, unspecified) - bacterial osteomyelitis; fungal bone infection requires specific B45.3 codeC79.51 (Secondary malignant neoplasm of bone) - lytic lesions from cryptococcosis can mimic metastatic disease on imaging