B27 - Infectious mononucleosis

Clinical Information

• Fatigue Syndrome, Chronic-. a syndrome characterized by persistent or recurrent fatigue, diffuse musculoskeletal pain, sleep disturbances, and subjective cognitive impairment of 6 months duration or longer. symptoms are not caused by ongoing exertion; are not relieved by rest; and result in a substantial reduction of previous levels of occupational, educational, social, or personal activities. minor alterations of immune, neuroendocrine, and autonomic function may be associated with this syndrome. there is also considerable overlap between this condition and fibromyalgia. (from semin neurol 1998;18(2):237-42; ann intern med 1994 dec 15;121(12): 953-9)
• Herpesvirus 4, Human-. the type species of lymphocryptovirus, subfamily gammaherpesvirinae, infecting b-cells in humans. it is thought to be the causative agent of infectious mononucleosis and is strongly associated with oral hairy leukoplakia (leukoplakia, hairy;), burkitt lymphoma; and other malignancies.
• Infectious Mononucleosis-. a common, acute infection usually caused by the epstein-barr virus (herpesvirus 4, human). there is an increase in mononuclear white blood cells and other atypical lymphocytes, generalized lymphadenopathy, splenomegaly, and occasionally hepatomegaly with hepatitis.
• Fibromyalgia-. a common nonarticular rheumatic syndrome characterized by myalgia and multiple points of focal muscle tenderness to palpation (trigger points). muscle pain is typically aggravated by inactivity or exposure to cold. this condition is often associated with general symptoms, such as sleep disturbances, fatigue, stiffness, headaches, and occasionally depression. there is significant overlap between fibromyalgia and the chronic fatigue syndrome (fatigue syndrome, chronic). fibromyalgia may arise as a primary or secondary disease process. it is most frequent in females aged 20 to 50 years. (from adams et al., principles of neurology, 6th ed, p1494-95)

Specific Coding for Infectious mononucleosis

Non-specific codes like B27 require more digits to indicate the appropriate level of specificity. Consider using any of the following ICD-10 codes with a higher level of specificity when coding for infectious mononucleosis:

Patient Education

Infectious Mononucleosis

Infectious mononucleosis, or "mono", is an infection usually caused by the Epstein-Barr virus. The virus spreads through saliva, which is why it's sometimes called "kissing disease." Mono occurs most often in teens and young adults. However, you can get it at any age. Symptoms of mono include:

• Fever
• Sore throat
• Swollen lymph glands

Sometimes you may also have a swollen spleen. Serious problems are rare.

A blood test can show if you have mono. Most people get better in two to four weeks. However, you may feel tired for a few months afterward. Treatment focuses on helping symptoms and includes medicines for pain and fever, warm salt water gargles and plenty of rest and fluids.

Code History

• FY 2023 - No Change, effective from 10/1/2022 through 9/30/2023
• FY 2022 - No Change, effective from 10/1/2021 through 9/30/2022
• FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
• FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
• FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
• FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
• FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
• FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016 (First year ICD-10-CM implemented into the HIPAA code set)