2027 ICD-10-CM Diagnosis Code B37.81Candidal esophagitis
ICD-10-CM Codes›A00–B99›B35-B49›B37
- Billable — Valid for Submission
- CC — Complication or Comorbidity
- Risk Adjusts — HCC 6
- Not Chronic
B37.81 is a billable ICD-10-CM diagnosis code for candidal esophagitis. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 368 through 370, 791, 793, 974 through 976. As a secondary diagnosis, it counts as a complication or comorbidity (CC) and moves an inpatient stay to a higher severity level within its MS-DRG family. It does not count, however, when the principal diagnosis is one of 24 closely related codes. Coders also document this condition as candidiasis of esophagus. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Esophageal disorders and Fungal infections.
For Medicare Advantage risk adjustment, B37.81 maps to CMS-HCC Category 6 (Opportunistic Infections) under the V28 model, adding a risk factor of about 0.381 for a community, non-dual, aged beneficiary in payment year 2027.
Code Identity
Code Classification
Medicare Risk Adjustment (HCC)Billing
B37.81 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.
- Candidiasis of esophagus
- Candidiasis of esophagus co-occurrent with human immunodeficiency virus infection
- Candidiasis of mouth and esophagus
- Disorder of gastrointestinal tract co-occurrent with human immunodeficiency virus infection
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to B37.81: 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
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.
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
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
Esophagus Disorders
Esophagus disorders are problems with how your esophagus works. The esophagus is the tube that carries food from your mouth to your stomach. You usually don't notice it unless you swallow something too big, hot, or cold. You might also notice it if something is wrong.
The full article covers:
- What are esophagus disorders?
- What causes esophagus disorders?
- What are common esophagus disorders?
- What are symptoms of esophagus disorders?
- How are esophagus disorders diagnosed?
- How are esophagus disorders treated?
- Can esophagus disorders be prevented?
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert B37.81 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About B37.81Overview
What is the ICD-10 code for candidal esophagitis?
The ICD-10-CM code for candidal esophagitis is B37.81 (sometimes written as B3781). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is B37.81 (Candidiasis of other sites) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report candidal esophagitis on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does B37.81 group to?
When candidal esophagitis is the principal diagnosis on an inpatient stay, it groups to MS-DRG 793, 791, 369, 974, 976, 975, 370, 368, with relative weights from 0.6741 to 4.2192 depending on complications. Higher weights mean higher Medicare reimbursement.
Is B37.81 a CC or MCC?
CMS lists B37.81 as a CC (complication or comorbidity) for FY 2027. Reported as a secondary diagnosis, it moves the inpatient stay to a higher-weighted DRG within its severity family. It does not count when the principal diagnosis is one of the 24 closely related codes in its exclusion list.
Can B37.81 be reported with P37.5?
Not as a rule. The Excludes1 note at B37, which applies to B37.81, 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 B37.81?
B37.81 (candidal esophagitis) maps to CMS-HCC Category 6 (Opportunistic Infections), commonly written as HCC 6, in the CMS-HCC V28 model used for Medicare Advantage risk adjustment in payment year 2027. It mapped to HCC 6 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 B37.81 risk-adjust for Medicare Advantage payment?
Yes. When documented and reported on a Medicare Advantage encounter, B37.81 adds a risk adjustment factor of about 0.381 to the beneficiary's RAF score for a community, non-dual, aged enrollee (published V28 weights range from 0.381 to 0.833 depending on the payment segment). HCC 6 sits at the top of its hierarchy, so no other condition category supersedes it. See the full factor table on the HCC 6 category page.
