What is ICD-10 code B67.1?

B67.1 is the ICD-10-CM diagnosis code for Echinococcus granulosus infection of lung. A parasitic infection caused by tapeworm larvae that form cysts in the lungs, potentially causing respiratory symptoms and complications. It belongs to the ICD-10-CM chapter for certain infectious and parasitic diseases (a00-b99). B67.1 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. B67.1 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. B67.1 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. B67.1 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 B67.1?

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. B67.1 was a payment HCC under V24 (Pneumococcal Pneumonia, Empyema, Lung Abscess) but the V28 recalibration removed it from the risk adjustment model. Both models can still appear in legacy data and in payer-specific lookback periods.

What should coders know when reporting B67.1?

Note any respiratory complications such as hemoptysis or pneumothorax in the clinical documentation Distinguish from liver involvement (B67.0) as lung cysts may require different treatment approaches Because B67.1 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 B67.1: Echinococcus granulosus

ICD-10-CM Code View

HCC Buddy Code Card

Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.

Code lookupB67.1Effective periodFY2026 Apr Update (Apr 1-Sep 30)

FY 2026 Apr update / Certain infectious and parasitic diseases (A00-B99) / Helminthiases (B65-B83)

B67.1

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

Echinococcus granulosus infection of lung

A parasitic infection caused by tapeworm larvae that form cysts in the lungs, potentially causing respiratory symptoms and complications.

Buddy Insight

Echinococcus granulosus infection of lung (pulmonary hydatid cyst) is caused by the larval stage of a dog tapeworm, forming slow-growing fluid-filled cysts in the lungs.

CMS-HCC V28

N/A

—

Not risk-adjusted for this model/period.

Not mapped

CMS-HCC V24

Mapped

HCC 115

Pneumococcal Pneumonia, Empye...

RAF 0.130

ACA/HHS

Mapped

HCC 163

HHS-HCC 163

Varies by metal level

ESRD/PACE

Mapped

HCC 115

Pneumococcal Pneumonia, Empye...

RAF 0.030

RXHCC

N/A

—

Not risk-adjusted for this model/period.

Not mapped

Code Book Path

Official

B67Echinococcosis

B67.1Echinococcus granulosus infection of lung

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for B67.1 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for B67.1 in this effective period.

Related Child Codes

Official

B67.0Echinococcus granulosus infection of liver

B67.2Echinococcus granulosus infection of bone

B67.3Echinococcus granulosus infection, other and multiple sites

B67.4Echinococcus granulosus infection, unspecified

B67.5Echinococcus multilocularis infection of liver

Includes

Official

hydatidosis

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for B67.1 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for B67.1 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for B67.1 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for B67.1 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

CT or MRI imaging showing well-defined cystic lesion(s) in the lung

Positive Echinococcus serology (IgG ELISA)

Documentation of cyst size, number, and complications (intact vs ruptured)

Geographic exposure history (sheep-raising regions, contact with dogs)

MEAT Support

HCC Buddy guidance

CT or MRI imaging showing well-defined cystic lesion(s) in the lung

Positive Echinococcus serology (IgG ELISA)

Documentation of cyst size, number, and complications (intact vs ruptured)

Geographic exposure history (sheep-raising regions, contact with dogs)

Audit Caution

HCC Buddy guidance

Confusing pulmonary hydatid cyst with lung abscess, congenital cyst, or malignancy on imaging — serology clarifies

Using the liver code (B67.0) when the cyst is in the lung — site-specific coding is required

Not documenting whether the cyst is intact or ruptured, which significantly impacts treatment approach

Failing to screen for concurrent hepatic cysts, which coexist in 10-20% of pulmonary cases

Common Mistakes

HCC Buddy guidance

B67.0 (Echinococcus granulosus infection of liver) - hepatic hydatid cysts are more common; lung cysts require B67.1

B67.39 (Echinococcus granulosus infection, other sites) - other sites outside liver and lung

D38.1 (Neoplasm of uncertain behavior of trachea, bronchus and lung) - hydatid cysts can be confused with pulmonary neoplasms on imaging

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 B67.1 an HCC code?

Yes. B67.1 maps to Pneumococcal Pneumonia, Empyema, Lung Abscess under the V24 model but is not retained in V28.

Code: B67.1
Description: Echinococcus granulosus infection of lung
HCC (V28): No CMS-HCC V28 mapping
RAF: —
Billable: Yes
Payment year: 2026

HCC Category Mapping

V24HCC 115, Pneumococcal Pneumonia, Empyema, Lung Abscess

0.130

ESRDHCC 115, Pneumococcal Pneumonia, Empyema, Lung Abscess

0.030

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 B67.1 in the Code Book — tabular path, V28 RAF, and MEAT checklist →

MEAT Criteria for B67.1

For B67.1 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 B67.1 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

Get the V28 RAF + MEAT cheat sheet

One printable page: confirm a code's V28 HCC status, its RAF weight, and the MEAT your note needs to make it stick. Free, no card.

Free PDF. No card. Unsubscribe anytime.

What This Code Means

B67.1 is the ICD-10-CM diagnosis code for echinococcus granulosus infection of lung. A parasitic infection caused by tapeworm larvae that form cysts in the lungs, potentially causing respiratory symptoms and complications. B67.1 sits in the ICD-10-CM chapter for certain infectious and parasitic diseases (a00-b99), within the section covering helminthiases (b65-b83).

Under the older CMS-HCC V24 model, B67.1 maps to Pneumococcal Pneumonia, Empyema, Lung Abscess (HCC 115) with a community, non-dual, aged base RAF weight of 0.130. 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.

Note any respiratory complications such as hemoptysis or pneumothorax in the clinical documentation. Because B67.1 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 B67.1 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Note any respiratory complications such as hemoptysis or pneumothorax in the clinical documentation
•Distinguish from liver involvement (B67.0) as lung cysts may require different treatment approaches

Clinical Significance

Echinococcus granulosus infection of lung (pulmonary hydatid cyst) is caused by the larval stage of a dog tapeworm, forming slow-growing fluid-filled cysts in the lungs. Cyst rupture can cause anaphylactic shock or secondary dissemination. This diagnosis requires careful surgical planning and is most common in immigrants from the Middle East, Mediterranean, Central Asia, and South America.

Documentation Requirements

✓CT or MRI imaging showing well-defined cystic lesion(s) in the lung
✓Positive Echinococcus serology (IgG ELISA)
✓Documentation of cyst size, number, and complications (intact vs ruptured)
✓Geographic exposure history (sheep-raising regions, contact with dogs)
✓Surgical approach documented if intervention planned (PAIR procedure or surgical excision)
✓Pre-operative albendazole therapy documented

Commonly Confused Codes

•B67.0 (Echinococcus granulosus infection of liver) - hepatic hydatid cysts are more common; lung cysts require B67.1
•B67.39 (Echinococcus granulosus infection, other sites) - other sites outside liver and lung
•D38.1 (Neoplasm of uncertain behavior of trachea, bronchus and lung) - hydatid cysts can be confused with pulmonary neoplasms on imaging