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B85 ICD-10-CM Code: Pediculosis and phthiriasis

B85 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · free HCC coding tools

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Code lookupB85

FY 2026 Apr update / Certain infectious and parasitic diseases (A00-B99) / Pediculosis, acariasis and other infestations (B85-B89)

B85

Header CodeICD-10-CMOfficial ICD-10-CMCodebook guidance

Pediculosis and phthiriasis

CMS-HCC V28

N/A

Not mapped

CMS-HCC V24

N/A

Not mapped

ACA/HHS

N/A

Not mapped

ESRD/PACE

N/A

Not mapped

RXHCC

N/A

Not mapped

Inclusion Terms

Official

No inclusion terms are included in this display for B85. 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

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 B85. 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 B85. Check the code and parent instructions in the Code Book.

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 →

Code
B85
Description
Pediculosis and phthiriasis
HCC (V28)
No CMS-HCC V28 mapping
RAF reference coefficient
Billable
No
Payment year
2026

Coder workflow notes

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What This Code Means

B85 is the ICD-10-CM diagnosis code for pediculosis and phthiriasis. B85 sits in the ICD-10-CM chapter for certain infectious and parasitic diseases (a00-b99), within the section covering pediculosis, acariasis and other infestations (b85-b89).

Header codes like B85 cannot be reported on claims directly; they organize child codes that share clinical context. Coders should select the billable child code that matches the documented presentation and then verify its current source-backed HCC mapping. Do not infer a child code or risk adjustment value from the header alone.

HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for B85 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Child Codes

Code Hierarchy

B85Pediculosis and phthiriasis
B85Pediculosis and phthiriasis

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