2026 ICD-10-CM Diagnosis Code B38.1Chronic pulmonary coccidioidomycosis
ICD-10-CM Codes›A00–B99›B35-B49›B38
- Billable — Valid for Submission
- CC — Complication or Comorbidity
- Chronic Condition
B38.1 is a billable ICD-10-CM diagnosis code for chronic pulmonary coccidioidomycosis. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 177 through 179, 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 16 closely related codes. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Fungal infections and Pneumonia (except that caused by tuberculosis).
B38.1 no longer risk-adjusts for Medicare Advantage: it mapped to HCC 115 under the retired CMS-HCC V24 model through payment year 2025 but maps to no category in the live V28 model. It still risk-adjusts in the PACE (CMS-HCC V22) category 115, ESRD (V21) category 115, and ESRD (V24) category 115 for payment year 2026.
Code Identity
Code Classification
Medicare Risk Adjustment (HCC)Billing
B38.1 no longer risk-adjusts for Medicare Advantage: it maps to no payment category in the live CMS-HCC V28 model, although it still risk-adjusts in the other CMS models shown below.
Source: CMS Payment Year 2026 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.
- Chronic coccidioidomycotic pneumonia
- Chronic pneumonia
- Chronic progressive coccidioidal pneumonia
- Chronic pulmonary coccidioidomycosis
- Infection by Coccidioides immitis
- Pneumonia with coccidioidomycosis
- Pulmonary coccidioidomycosis
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
coccidioidal (primary) (progressive) B38.7
lung B38.1
lung (infectious) See Also: Fibrosis, lung;
coccidioidal B38.1
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Clinical InformationClinical
Coccidioidal Meningitis
meningitis caused by a fungus of the genus coccidioides, endemic to the southwestern united states, south-central washington state, and parts of mexico and central and south america.Coccidioidomycosis
infection with a fungus of the genus coccidioides, endemic to the southwestern united states. it is sometimes called valley fever but should not be confused with rift valley fever. infection is caused by inhalation of airborne, fungal particles known as arthroconidia, a form of fungal spores. a primary form is an acute, benign, self-limited respiratory infection. a secondary form is a virulent, severe, chronic, progressive granulomatous disease with systemic involvement. it can be detected by use of coccidioidin.
Patient EducationClinical
Valley Fever
Valley Fever is a disease caused by a fungus (or mold) called Coccidioides. The fungi live in the soil of dry areas like the southwestern U.S. You get it from inhaling the spores of the fungus. The infection cannot spread from person to person.
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert B38.1 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About B38.1Overview
What is the ICD-10 code for chronic pulmonary coccidioidomycosis?
The ICD-10-CM code for chronic pulmonary coccidioidomycosis is B38.1 (sometimes written as B381). It is billable on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
Is B38.1 (Coccidioidomycosis) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report chronic pulmonary coccidioidomycosis on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What MS-DRG does B38.1 group to?
When chronic pulmonary coccidioidomycosis is the principal diagnosis on an inpatient stay, it groups to MS-DRG 177, 178, 179, 974, 975, 976, with relative weights from 0.7550 to 2.8860 depending on complications. Higher weights mean higher Medicare reimbursement.
Is B38.1 a CC or MCC?
CMS lists B38.1 as a CC (complication or comorbidity) for FY 2026. 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 16 closely related codes in its exclusion list.
What is the ICD-9 equivalent of B38.1?
Under the General Equivalence Mappings, chronic pulmonary coccidioidomycosis converts to ICD-9-CM 114.4 (ch pl coccidioidomycosis). The mapping is a direct match.
Does B38.1 risk-adjust for Medicare Advantage payment?
Not for Medicare Advantage. B38.1 mapped to HCC 115 in the retired CMS-HCC V24 model, which last determined payment in 2025, but it maps to no category in the live V28 model; see all codes that no longer risk-adjust. It still risk-adjusts in the PACE (CMS-HCC V22) category 115 (Pneumococcal Pneumonia/Empyema/Lung Abscess), ESRD (V21) category 115 (Pneumococcal Pneumonia/Empyema/Lung Abscess), and ESRD (V24) category 115 (Pneumococcal Pneumonia/Empyema/Lung Abscess).
