2027 ICD-10-CM Diagnosis Code B37.7Candidal sepsis
ICD-10-CM Codes›A00–B99›B35-B49›B37
- Billable — Valid for Submission
- MCC — Major Complication or Comorbidity
- Risk Adjusts — HCC 2
- Not Chronic
B37.7 is a billable ICD-10-CM diagnosis code for candidal sepsis. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 870 through 872. As a secondary diagnosis, it counts as a major complication or comorbidity (MCC) and places an inpatient stay in the highest severity level of its MS-DRG family. It does not count, however, when the principal diagnosis is one of 65 closely related codes. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Fungal infections and Septicemia.
For Medicare Advantage risk adjustment, B37.7 maps to CMS-HCC Category 2 (Septicemia, Sepsis, Systemic Inflammatory Response Syndrome/Shock) under the V28 model, adding a risk factor of about 0.500 for a community, non-dual, aged beneficiary in payment year 2027.
Code Identity
Code Classification
Medicare Risk Adjustment (HCC)Billing
B37.7 maps to a payment category in the CMS-HCC model used to risk-adjust Medicare Advantage payments. Weights are the published community factors for payment year 2027.
Source: CMS Payment Year 2027 risk adjustment mappings and model software. Weights are relative factors, not dollar amounts; a beneficiary's total RAF also includes demographics and interactions. Browse all CMS-HCC categories.
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Acute disseminated candidiasis
- Candidemia
- Candidemia associated with intravascular line
- Chronic disseminated candidiasis
- Disseminated candidiasis
- Disseminated candidiasis with AIDS
- Disseminated cutaneous candidiasis
- Disseminated cutaneous mycosis
- Fungemia
- Neonatal candidiasis
- Neonatal systemic candidiasis
- Sepsis caused by Candida
- Sepsis caused by fungus
- Systemic candidiasis with skin involvement
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to B37.7: its own notes plus those printed at B37, block B35-B49, and Chapter 1. A note printed at a category, block or chapter applies to every code under it.
Includes
Further defines, or gives examples of, the content of the category.
- candidosis
- moniliasis
- diseases generally recognized as communicable or transmissible
Applicable To
Conditions this code is used for: synonyms of the title or, for "other specified" codes, the conditions assigned to it. The list is not exhaustive.
- Disseminated candidiasis
- Systemic candidiasis
Excludes1
Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.
Excludes2
Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.
- carrier or suspected carrier of infectious disease (Z22.-)
- certain localized infections - see body system-related chapters
- infectious and parasitic diseases complicating pregnancy, childbirth and the puerperium (O98.-)
- infectious and parasitic diseases specific to the perinatal period (P35-P39)
- influenza and other acute respiratory infections (J00-J22)
Use Additional Code
Add a second code, after this one, to fully describe the condition.
- code to identify resistance to antimicrobial drugs (Z16.-)
Source: CMS ICD-10-CM Tabular List. How to read instructional notes.
Referenced in Other NotesGuidance
Instructional notes printed at other codes that name B37.7, its category, or a range that includes it.
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
disseminated B37.7
sepsis B37.7
systemic B37.7
candida B37.7
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Clinical InformationClinical
Candidiasis
infection with a fungus of the genus candida. it is usually a superficial infection of the moist areas of the body and is generally caused by candida albicans. (dorland, 27th ed)
Patient EducationClinical
Sepsis
Sepsis is your body's overactive and extreme response to an infection. Sepsis is a life-threatening medical emergency. Without quick treatment, it can lead to tissue damage, organ failure, and even death.
The full article covers:
- What is sepsis?
- What causes sepsis?
- Who is more likely to develop sepsis?
- What are the symptoms of sepsis?
- What other problems can sepsis cause?
- How is sepsis diagnosed?
- What are the treatments for sepsis?
- Can sepsis be prevented?
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert B37.7 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About B37.7Overview
What is the ICD-10 code for candidal sepsis?
The ICD-10-CM code for candidal sepsis is B37.7 (sometimes written as B377). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is B37.7 (Candidiasis) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report candidal sepsis on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does B37.7 group to?
When candidal sepsis is the principal diagnosis on an inpatient stay, it groups to MS-DRG 872, 871, 870, with relative weights from 1.0066 to 6.9432 depending on complications. Higher weights mean higher Medicare reimbursement.
Is B37.7 a CC or MCC?
CMS lists B37.7 as an MCC (major complication or comorbidity) for FY 2027. Reported as a secondary diagnosis, it places the inpatient stay in the highest-weighted DRG of its severity family. It does not count when the principal diagnosis is one of the 65 closely related codes in its exclusion list.
Can B37.7 be reported with P37.5?
Not as a rule. The Excludes1 note at B37, which applies to B37.7, lists "neonatal candidiasis (P37.5)". An Excludes1 note means the excluded code is never reported together with this one; the only exception is when the two conditions are unrelated to each other (Official Guidelines, Section I.A.12.a).
What HCC is B37.7?
B37.7 (candidal sepsis) maps to CMS-HCC Category 2 (Septicemia, Sepsis, Systemic Inflammatory Response Syndrome/Shock), commonly written as HCC 2, in the CMS-HCC V28 model used for Medicare Advantage risk adjustment in payment year 2027. It mapped to HCC 2 under the retired V24 model. It also maps in the PACE (CMS-HCC V22), ESRD (V21), and ESRD (V24) models. In the Part D prescription drug model it maps to RxHCC 5.
Does B37.7 risk-adjust for Medicare Advantage payment?
Yes. When documented and reported on a Medicare Advantage encounter, B37.7 adds a risk adjustment factor of about 0.500 to the beneficiary's RAF score for a community, non-dual, aged enrollee (published V28 weights range from 0.447 to 0.780 depending on the payment segment). HCC 2 sits at the top of its hierarchy, so no other condition category supersedes it. See the full factor table on the HCC 2 category page.
