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B45.7 ICD-10-CM Code: Disseminated cryptococcosis

B45.7 maps to CMS-HCC V28 6. A source-labeled RAF reference is available. Confirm the documented diagnosis and applicable coding requirements. MEAT criteria · RAF Calculator · free HCC coding tools

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Code lookupB45.7

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

B45.7

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

Disseminated cryptococcosis

Disseminated cryptococcosis is a serious fungal infection caused by Cryptococcus that has spread throughout the body, commonly affecting the lungs, brain, and bloodstream. This condition typically occurs in people with weakened immune systems, such as those with HIV/AIDS or undergoing immunosuppressive therapy.

Buddy the Bee presenting code insight

Buddy Insight

Disseminated cryptococcosis indicates Cryptococcus infection spread through the bloodstream to multiple organ systems, representing one of the most serious opportunistic infections with high mortality.

OverviewRisk ModelsCode BookDocumentationAuditNotesEdition comparison

CMS-HCC V28

HCC 6

Coefficient HCC 6: 0.381 (Community Non-Dual Aged (CNA))

CMS-HCC V24

Historical

Historical

Not used for CY2026 payment

ACA/HHS

HCC 006

Code-level coefficient reference

ESRD/PACE

HCC 6

Code-level coefficient reference

RXHCC

HCC 5

Code-level coefficient reference

Code Book Path

Official
B45CryptococcosisB45.7Disseminated cryptococcosis

Inclusion Terms

Official
  • Generalized cryptococcosis

Excludes 2

Official
  • carrier or suspected carrier of infectious disease (Z22.-)Inherited from A00-B99, B35-B49
  • infectious and parasitic diseases complicating pregnancy, childbirth and the puerperium (O98.-)Inherited from A00-B99, B35-B49
  • infectious and parasitic diseases specific to the perinatal period (P35-P39)Inherited from A00-B99, B35-B49
  • influenza and other acute respiratory infections (J00-J22)Inherited from A00-B99, B35-B49
  • hypersensitivity pneumonitis due to organic dust (J67.-)Inherited from A00-B99, B35-B49
  • mycosis fungoides (C84.0-)Inherited from A00-B99, B35-B49

Related Codes

Official
B45.0Pulmonary cryptococcosisB45.1Cerebral cryptococcosisB45.2Cutaneous cryptococcosisB45.3Osseous cryptococcosisB45.8Other forms of cryptococcosis

Includes

Official
  • diseases generally recognized as communicable or transmissibleInherited from A00-B99

Excludes 1

Official
  • certain localized infections - see body system-related chaptersInherited from A00-B99

Code First

Official

No Code First sequencing instructions are included in this display for B45.7. Check the code and parent instructions in the Code Book.

Use Additional

Official
  • code to identify resistance to antimicrobial drugs (Z16.-)Inherited from A00-B99

Code Also

Official

No Code Also instructions are included in this display for B45.7. Check the code and parent instructions in the Code Book.

Buddy Documentation Tip

HCC Buddy guidance
Positive cryptococcal antigen or cultures from two or more body sites
Documentation of specific organ systems involved (lung, brain, skin, blood, bone)
Fungemia documented if blood cultures are positive
CD4 count or other marker of immunosuppression severity

MEAT Support

HCC Buddy guidance
Positive cryptococcal antigen or cultures from two or more body sites
Documentation of specific organ systems involved (lung, brain, skin, blood, bone)
Fungemia documented if blood cultures are positive
CD4 count or other marker of immunosuppression severity

Audit Caution

HCC Buddy guidance
Using site-specific codes (B45.0, B45.1) individually when documentation supports multi-system disseminated disease — B45.7 captures the systemic nature
Failing to code all individual organ manifestations in addition to the disseminated code when documentation supports both approaches
Not coding the underlying immunodeficiency (HIV, transplant status) that enabled dissemination

Common Mistakes

HCC Buddy guidance
B45.0 (Pulmonary cryptococcosis) - use when ONLY the lungs are affected
B45.1 (Cerebral cryptococcosis) - use when ONLY the central nervous system is affected
B45.9 (Cryptococcosis, unspecified) - never use when multi-organ involvement is documented; disseminated is a specific diagnosis

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 B45.7 an HCC code?

Yes. B45.7 (Disseminated cryptococcosis) maps to HCC 6, Opportunistic Infections under the CMS-HCC V28 risk adjustment model, with a source-labeled community non-dual aged reference coefficient of 0.381. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes. It is billable for payment year 2026.

Coder answer: B45.7 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
B45.7
Description
Disseminated cryptococcosis
HCC (V28)
HCC 6 — Opportunistic Infections
RAF reference coefficient
0.381
Billable
Yes
Payment year
2026

HCC Category Mapping

V28HCC 6, Opportunistic Infections
0.381
ESRDHCC 6, Opportunistic Infections
Not separately weighted
RxHCCHCC 5, Opportunistic Infections
Not separately weighted

These are source-labeled model coefficients, not member totals. A category may still be removed by hierarchy or model cleanup rules. 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 context, hierarchy and cleanup rules, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains available for historical review.

Work B45.7 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT review for B45.7

For B45.7, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule.

  • 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

Coder workflow notes

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What This Code Means

B45.7 is the ICD-10-CM diagnosis code for disseminated cryptococcosis. Disseminated cryptococcosis is a serious fungal infection caused by Cryptococcus that has spread throughout the body, commonly affecting the lungs, brain, and bloodstream. This condition typically occurs in people with weakened immune systems, such as those with HIV/AIDS or undergoing immunosuppressive therapy. B45.7 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, B45.7 maps to Opportunistic Infections (HCC 6) with a source-labeled community, non-dual, aged reference coefficient of 0.381. No V24 mapping is shown for B45.7; use the applicable model and payment year when reviewing the V28 mapping. For CY2026 non-PACE Medicare Advantage, CMS uses 100% of the 2024 CMS-HCC model (V28). PACE uses a separate model blend. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes.

Always verify the extent of dissemination and document which body systems are affected, as this may require additional codes for specific site involvement (e.g., meningitis, pneumonia). For B45.7, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule. 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, source-labeled coefficient references, and MEAT documentation criteria for B45.7 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • •Always verify the extent of dissemination and document which body systems are affected, as this may require additional codes for specific site involvement (e.g., meningitis, pneumonia)
  • •Ensure the underlying immunocompromised condition is also coded separately, as cryptococcosis is an opportunistic infection that requires documentation of the primary immune disorder

Clinical Significance

Disseminated cryptococcosis indicates Cryptococcus infection spread through the bloodstream to multiple organ systems, representing one of the most serious opportunistic infections with high mortality. It is a hallmark of advanced immunosuppression, particularly AIDS, and demands aggressive combination antifungal therapy and management of the underlying immunodeficiency.

Documentation Requirements

  • ✓Positive cryptococcal antigen or cultures from two or more body sites
  • ✓Documentation of specific organ systems involved (lung, brain, skin, blood, bone)
  • ✓Fungemia documented if blood cultures are positive
  • ✓CD4 count or other marker of immunosuppression severity
  • ✓Complete treatment plan including induction, consolidation, and maintenance therapy phases

Commonly Confused Codes

  • •B45.0 (Pulmonary cryptococcosis) - use when ONLY the lungs are affected
  • •B45.1 (Cerebral cryptococcosis) - use when ONLY the central nervous system is affected
  • •B45.9 (Cryptococcosis, unspecified) - never use when multi-organ involvement is documented; disseminated is a specific diagnosis

Child Codes

B45.0Pulmonary cryptococcosis
HCC 6
B45.1Cerebral cryptococcosis
HCC 6
B45.2Cutaneous cryptococcosis
HCC 6
B45.3Osseous cryptococcosis
HCC 6
B45.7Disseminated cryptococcosis
HCC 6
B45.8Other forms of cryptococcosis
HCC 6
B45.9Cryptococcosis, unspecified
HCC 6

Code Hierarchy

└B45Cryptococcosis└B45.7Disseminated cryptococcosis
└B45.7Disseminated cryptococcosis

Also searched as

  • B45 7
  • B457

For B45.7, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule.

B45.7 maps to CMS-HCC V28 category 6, Opportunistic Infections. See the ICD-10 to HCC mapping hub for how the V28 crosswalk works. The mapping identifies a payment HCC category for B45.7. Review its source-labeled HCC coefficient above, check the RAF Calculator with complete member context for CMS-HCC V28 PY2026, and confirm the documentation the chart needs before the code is submitted. HCC Buddy shows no RAF score unless every required source and calculation check passes.

Work B45.7 in HCC Buddy

Open B45.7 in the Code Book for the full Index-to-Tabular path, MEAT checklist, and V28 HCC mapping, or in the Encoder to code from a keyword search. Pro includes 7 days to try everything, no card required.

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