B55.1 ICD-10-CM Code: Cutaneous leishmaniasis
B55.1 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · HCC Buddy coding tools
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FY 2026 Apr update / Certain infectious and parasitic diseases (A00-B99) / Protozoal diseases (B50-B64)
B55.1
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceCutaneous leishmaniasis
A parasitic infection caused by Leishmania that causes skin sores and ulcers, typically on exposed areas of the body.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
HistoricalHistorical
Not used for CY2026 payment
ACA/HHS
N/A—
Not mapped
ESRD/PACE
N/A—
Not mapped
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
OfficialNo inclusion terms are included in this display for B55.1. Check the code and parent instructions in the Code Book.
Excludes 2
Official- carrier or suspected carrier of infectious disease (Z22.-)Inherited from A00-B99
- infectious and parasitic diseases complicating pregnancy, childbirth and the puerperium (O98.-)Inherited from A00-B99
- infectious and parasitic diseases specific to the perinatal period (P35-P39)Inherited from A00-B99
- influenza and other acute respiratory infections (J00-J22)Inherited from A00-B99
Related Codes
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, B50-B64
- amebiasis (A06.-)Inherited from A00-B99, B50-B64
- other protozoal intestinal diseases (A07.-)Inherited from A00-B99, B50-B64
Code First
OfficialNo Code First sequencing instructions are included in this display for B55.1. 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
OfficialNo Code Also instructions are included in this display for B55.1. Check the code and parent instructions in the Code Book.
Buddy Documentation Tip
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 B55.1 an HCC code?
No. B55.1 is a billable ICD-10-CM code with no mapping under the current CMS-HCC V28 community payment model, and none under the ESRD, Part D RxHCC, or HHS-HCC models.
- Code
- B55.1
- Description
- Cutaneous leishmaniasis
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF reference coefficient
- —
- Billable
- Yes
- Payment year
- 2026
Coder workflow notes
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What This Code Means
B55.1 is the ICD-10-CM diagnosis code for cutaneous leishmaniasis. A parasitic infection caused by Leishmania that causes skin sores and ulcers, typically on exposed areas of the body. B55.1 sits in the ICD-10-CM chapter for certain infectious and parasitic diseases (a00-b99), within the section covering protozoal diseases (b50-b64).
B55.1 is a billable ICD-10-CM code, but no current CMS-HCC V28 community payment mapping is shown, and none under the ESRD, Part D RxHCC, or HHS-HCC models. Do not assign risk adjustment value from this page when no source-backed mapping is shown; verify the applicable model and payment year.
Document the location and number of skin lesions; note if lesions are localized or disseminated.
HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for B55.1 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Document the location and number of skin lesions; note if lesions are localized or disseminated
- •Cutaneous leishmaniasis is the most common form; distinguish from mucocutaneous form if present