B74.3 ICD-10-CM Code: Loiasis
HCC Buddy Code Card
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FY 2026 Apr update / Certain infectious and parasitic diseases (A00-B99) / Helminthiases (B65-B83)
B74.3
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceLoiasis
Loiasis is a parasitic infection caused by a worm that lives in the bloodstream and tissues, transmitted through the bite of infected flies, primarily affecting people in Africa and parts of Asia. The infection can cause swelling, itching, and the visible movement of the worm under the skin.
CMS-HCC V28
00
RAF 0
CMS-HCC V24
00
RAF 0
ACA/HHS
00
RAF 0
ESRD/PACE
00
RAF 0
RXHCC
00
RAF 0
Code Trumping
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Code Book Path
Inclusion Terms
Official- Calabar swelling
- Eyeworm disease of Africa
- Loa loa infection
Excludes 2
Official- onchocerciasis (B73)
- tropical (pulmonary) eosinophilia NOS (J82.89)
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for B74.3 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for B74.3 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for B74.3 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for B74.3 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for B74.3 in this effective period.
Buddy Documentation Tip
Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.
Is B74.3 an HCC code?
No. B74.3 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
Coder workflow notes
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This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
B74.3 is the ICD-10-CM diagnosis code for loiasis. Loiasis is a parasitic infection caused by a worm that lives in the bloodstream and tissues, transmitted through the bite of infected flies, primarily affecting people in Africa and parts of Asia. The infection can cause swelling, itching, and the visible movement of the worm under the skin. B74.3 sits in the ICD-10-CM chapter for certain infectious and parasitic diseases (a00-b99), within the section covering helminthiases (b65-b83).
B74.3 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.
Loiasis is an infectious disease that requires documentation of the specific site of infection if applicable, as the worm can migrate to various body locations including the eye (subconjunctival space).
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for B74.3 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Loiasis is an infectious disease that requires documentation of the specific site of infection if applicable, as the worm can migrate to various body locations including the eye (subconjunctival space)
- •This code is typically used for patients with a history of travel to endemic regions or those presenting with characteristic symptoms like Calabar swellings (transient subcutaneous swellings) or eye involvement