2027 ICD-10-CM Diagnosis Code B48.4Penicillosis
ICD-10-CM Codes›A00–B99›B35-B49›B48
- Billable — Valid for Submission
- CC — Complication or Comorbidity
- Risk Adjusts — HCC 6
- Not Chronic
B48.4 is a billable ICD-10-CM diagnosis code for penicillosis. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 791, 793, 867 through 869. 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 12 closely related codes. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Fungal infections.
For Medicare Advantage risk adjustment, B48.4 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
B48.4 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.
- Disseminated infection caused by Talaromyces marneffei
- Infection caused by Penicillium
- Infection caused by Penicillium chrysogenum
- Infection caused by Penicillium citreonigrum
- Infection caused by Penicillium citrinum
- Infection caused by Penicillium commune
- Infection caused by Penicillium crustaceum
- Infection caused by Penicillium cyclopium
- Infection caused by Penicillium expansum
- Infection caused by Penicillium frequentans
- Infection caused by Penicillium glaucum
- Infection caused by Penicillium griseofulvum
- Infection caused by Penicillium islandicum
- Infection caused by Penicillium mycetomagenum
- Infection caused by Penicillium oxalicum
- Infection caused by Penicillium palitans
- Infection caused by Penicillium puberulum
- Infection caused by Penicillium purpurogenum
- Infection caused by Penicillium roqueforte
- Infection caused by Penicillium rugulosum
- Infection caused by Penicillium spinulosum
- Infection caused by Penicillium suberi
- Infection caused by Penicillium verrucosum
- Infection caused by Penicillium verruculosum
- Infection caused by Penicillium viridicatum
- Infection caused by Talaromyces bacillisporus
- Infection caused by Talaromyces marneffei
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to B48.4: its own notes plus those printed at 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.
- 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.
- Talaromycosis
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
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Patient EducationClinical
Fungal Infections
If you have ever had athlete's foot or a yeast infection, you can blame a fungus. A fungus is a primitive organism. Mushrooms, mold and mildew are examples. Fungi live in air, in soil, on plants and in water. Some live in the human body. Only about half of all types of fungi are harmful.
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert B48.4 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About B48.4Overview
What is the ICD-10 code for penicillosis?
The ICD-10-CM code for penicillosis is B48.4 (sometimes written as B484). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is B48.4 (Other mycoses, not elsewhere classified) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report penicillosis on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does B48.4 group to?
When penicillosis is the principal diagnosis on an inpatient stay, it groups to MS-DRG 793, 791, 867, 869, 868, with relative weights from 0.6784 to 4.2192 depending on complications. Higher weights mean higher Medicare reimbursement.
Is B48.4 a CC or MCC?
CMS lists B48.4 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 12 closely related codes in its exclusion list.
What is the ICD-9 equivalent of B48.4?
Under the General Equivalence Mappings, penicillosis converts to ICD-9-CM 117.3 (aspergillosis). The mapping is approximate, so confirm the match fits the documentation.
What HCC is B48.4?
B48.4 (penicillosis) 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 B48.4 risk-adjust for Medicare Advantage payment?
Yes. When documented and reported on a Medicare Advantage encounter, B48.4 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.
