B37.1 ICD-10-CM Code: Pulmonary candidiasis

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for B37.1 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2026Effective: October 1, 2025

Notes without a marker are published on B37.1 itself; “inherited from” names the category or block whose note applies here.

This page already reflects the FY2027 tabular notes taking effect October 1, 2026.

Coder workflow for B37.1

MedCoder structured workflow — derived from this code’s own official record

Before you code B37.1

1. Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with B37.1. Excludes1 conditions are not reported together with this code unless the record shows they are unrelated (Guidelines I.A.12.a).

   See the official tabular notes

Choose the right path

1. Does the documentation support a condition named in B37.1’s Excludes1 note?
   Yes → Do not simply proceed: review the excluded code. Both are reported only when the record shows the two conditions are unrelated.
   No → Continue.

   ReviewP37.5

Consider B37.1. Then review the Code Also note, and confirm the code is valid for the date of service in the Verify section.

Documentation check

The provider’s diagnostic statement

Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).

Official instructions as workflow

• Excludes1 — check before selecting B37.1(1 note)

  Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with B37.1: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.

  CompareP37.5

  See the official tabular notes · Guidelines I.A.12.a

• Excludes2 — not part of B37.1(2 notes)

  Coding workflow: The conditions named in this note are not included in B37.1. When the record documents both, both may be reported; the note is a boundary, not a prohibition.

  CompareJ67, C84.0

  See the official tabular notes · Guidelines I.A.12.b

• Code Also — related condition(2 notes)

  Coding workflow: Review the related condition when both are documented and the instruction applies. A Code Also note does not fix sequencing; the order follows the circumstances of the encounter.

  ReviewJ4B

  See the official tabular notes · Guidelines I.A.17

Coding decision scenarios

Pattern scenarios for this code’s structure — decision rules, not clinical cases

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Indexed Clinical Terms (7)

Official source data — entries quoted as published, in the Index’s own lookup phrasing

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code. These are alphabetic-index entries shown as the Index writes them — lookup phrasing, not necessarily the wording of a final diagnosis.

• Bronchomycosis NOS, candidal
• Candidiasis, candidal, bronchitis
• Candidiasis, candidal, lung
• Candidiasis, candidal, pneumonia
• Candidiasis, candidal, pulmonary
• Pneumonia (acute) (double) (migratory) (purulent) (septic) (unresolved), Candida
• Pneumonia (acute) (double) (migratory) (purulent) (septic) (unresolved), in (due to), candidiasis

Don’t confuse B37.1 with…

MedCoder analysis — pairs from this code’s official notes, distinctions written by MedCoder

The codes most likely to be picked instead of B37.1 — named in its own official notes, or sharing its laterality or encounter family — with what separates them and which documentation moves the case. Each links to the full comparison.

• P37.5— Excludes1 conflict (Excludes1 — generally not reported together)

  Not coded here — the tabular list excludes this pair for the same encounter.

  Not reported together with this code, except where the two conditions are documented as unrelated.

  What moves you there: Documentation of neonatal candidiasis moves the case to P37.5; the two are not reported together unless documented as unrelated.

  Full comparison: B37.1 vs P37.5 →

• B37.9— Specificity relationship (Review)

  Overlapping diagnoses in the same category.

  Overlapping codes in the same category — the documentation decides which is the more specific fit.

  What moves you there: A record that documents no more than “Candidiasis, unspecified” takes B37.9; specificity in the record moves it back here.

  Full comparison: B37.1 vs B37.9 →

• J67— Excludes2 relationship (Informational)

  Distinct conditions — both may be reported.

  A distinct condition — both may be reported when both are documented.

  What moves you there: Documentation of hypersensitivity pneumonitis due to organic dust adds J67; it is not part of this code and both may be reported when both are documented.

  Full comparison: B37.1 vs J67 →

• C84.0— Excludes2 relationship (Informational)

  Distinct conditions — both may be reported.

  A distinct condition — both may be reported when both are documented.

  What moves you there: Documentation of mycosis fungoides adds C84.0; it is not part of this code and both may be reported when both are documented.

  Full comparison: B37.1 vs C84.0 →

Relationships are read from this code's own official notes, its laterality siblings and its encounter family; the wording of each distinction is MedCoder editorial, and the documentation named in each “what moves you there” line is the official note phrase or sibling title itself. Source: CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a.

Decision Points

The directives on this code's own record, as a pre-claim checklist.

1. 2 Code Also notes — a second code may apply; the guidelines leave its sequencing to the circumstances of the encounter. See the Code Also notes
2. 1 Excludes1 entry — codes named there are generally not reported together with this code (Guidelines I.A.12.a). See the Excludes1 notes
3. 2 Excludes2 entries — those conditions are not part of this code and may be reported additionally when documented. See the Excludes2 notes

Checklist rows are derived from this code's own official directives; the wording of each check is MedCoder editorial. The official notes themselves are in the sections each row links to.

Verify Before Coding

• MCC as a secondary diagnosis (FY2026). Can raise the stay's MS-DRG severity tier.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Relationships & Classification

MedCoder structured relationships — computed from published CMS and AHRQ datasets

Other codes that name B37.1 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.

Referenced by 2 Excludes1 notes: J17 — Pneumonia in diseases classified elsewhere, J99 — Respiratory disorders in diseases classified elsewhere.

These codes’ tabular lists mark this diagnosis as mutually exclusive — not reported together unless the conditions are documented as unrelated.

Referenced by 1 Code First instruction: M01 — Direct infections of joint in infectious and parasitic diseases classified elsewhere (via B37.-).

Each of these codes carries a Code First note naming this condition — when that code is reported, THIS code is sequenced first, ahead of it.

Referenced by 1 Code Also instruction: J4B — Pulmonary mycetoma.

These codes suggest coding this condition alongside when both are present.

MS-DRG Grouper Relationships (FY2026)

Potential MS-DRG participation — not a DRG assignment.

FY2026 MS-DRG: MCC — Major Complication or Comorbidity. Reported as a secondary diagnosis, this code raises the stay's MS-DRG severity tier — except when the principal diagnosis is one of 23 clinically related codes on its CMS exclusion list. Does not count toward severity when the stay groups to DRGs 974-976 (HIV with Major Related Condition).

Named in the grouper logic of 8 MS-DRGs: DRG 177 (MDC 04), DRG 178 (MDC 04), DRG 179 (MDC 04), DRG 791 (MDC 15), DRG 793 (MDC 15), DRG 974 (MDC 25), DRG 975 (MDC 25), DRG 976 (MDC 25).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):RSP002 — Pneumonia (except that caused by tuberculosis) (default); INF004 — Fungal infections.

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Related Codes

Same clinical process (MS-DRG)

Acts as MCC — raises the severity of other admissions. CMS groups these diagnoses into one MS-DRG principal-diagnosis exclusion process — a CC/MCC on this list never raises severity when the principal diagnosis is also on it.

B37.0 — Candidal stomatitis, B37.2 — Candidiasis of skin and nail, B37.31 — Acute candidiasis of vulva and vagina, B37.32 — Chronic candidiasis of vulva and vagina, B37.41 — Candidal cystitis and urethritis, B37.42 — Candidal balanitis, B37.49 — Other urogenital candidiasis, B37.5 — Candidal meningitis, B37.6 — Candidal endocarditis, B37.7 — Candidal sepsis, B37.81 — Candidal esophagitis, B37.82 — Candidal enteritis, B37.83 — Candidal cheilitis, B37.84 — Candidal otitis externa, B37.89 — Other sites of candidiasis, B37.9 — Candidiasis, unspecified, B48.3 — Geotrichosis, B49 — Unspecified mycosis, B92 — Sequelae of leprosy, B94.2 — Sequelae of viral hepatitis, +2 more

Same CMS-HCC risk category (V28)

CMS maps these diagnoses to the same Hierarchical Condition Category (Opportunistic Infections) for risk-adjusted payment.

A07.2 — Cryptosporidiosis, A31.0 — Pulmonary mycobacterial infection, A31.2 — Disseminated mycobacterium avium-intracellulare complex (DMAC), B25.0 — Cytomegaloviral pneumonitis, B25.1 — Cytomegaloviral hepatitis, B25.2 — Cytomegaloviral pancreatitis, B25.8 — Other cytomegaloviral diseases, B25.9 — Cytomegaloviral disease, unspecified, B37.7 — Candidal sepsis, B37.81 — Candidal esophagitis, B44.0 — Invasive pulmonary aspergillosis, B44.1 — Other pulmonary aspergillosis, B44.2 — Tonsillar aspergillosis, B44.7 — Disseminated aspergillosis, B44.89 — Other forms of aspergillosis, B44.9 — Aspergillosis, unspecified, B45.0 — Pulmonary cryptococcosis, B45.1 — Cerebral cryptococcosis, B45.2 — Cutaneous cryptococcosis, B45.3 — Osseous cryptococcosis, +16 more

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical categories (Pneumonia (except that caused by tuberculosis), Fungal infections).

B35.6 — Tinea cruris, B35.8 — Other dermatophytoses, B35.9 — Dermatophytosis, unspecified, B36.0 — Pityriasis versicolor, B36.1 — Tinea nigra, B36.2 — White piedra, B36.3 — Black piedra, B36.8 — Other specified superficial mycoses, B36.9 — Superficial mycosis, unspecified, B37.0 — Candidal stomatitis, B37.2 — Candidiasis of skin and nail, B37.3 — Candidiasis of vulva and vagina, B37.31 — Acute candidiasis of vulva and vagina, B37.32 — Chronic candidiasis of vulva and vagina, B37.41 — Candidal cystitis and urethritis, B37.42 — Candidal balanitis, B37.49 — Other urogenital candidiasis, B37.5 — Candidal meningitis, B37.6 — Candidal endocarditis, B37.7 — Candidal sepsis, +147 more

Same Index main term, other category

The ICD-10-CM Index to Diseases and Injuries files this code under the main terms “Pneumonia”, “Bronchomycosis NOS”; these codes share that main term but sit in a different category of the Tabular List.

A43.0 — Pulmonary nocardiosis (in, nocardiosis, nocardiasis), A50.04 — Early congenital syphilitic pneumonia (alba), A54.84 — Gonococcal pneumonia (gonococcal), A69.8 — Other specified spirochetal infections (spirochetal NEC), A70 — Chlamydia psittaci infections (psittacosis), A78 — Q fever (in, Q fever), B01.2 — Varicella pneumonia (varicella), B05.2 — Measles complicated by pneumonia (giant cell), B06.81 — Rubella pneumonia (in, rubella), B25.0 — Cytomegaloviral pneumonitis (cytomegaloviral), B38.0 — Acute pulmonary coccidioidomycosis (in, coccidioidomycosis, acute), B38.1 — Chronic pulmonary coccidioidomycosis (in, coccidioidomycosis, chronic), B38.2 — Pulmonary coccidioidomycosis, unspecified (in, coccidioidomycosis), B39.0 — Acute pulmonary histoplasmosis capsulati (in, histoplasmosis, acute), B39.1 — Chronic pulmonary histoplasmosis capsulati (in, histoplasmosis, chronic), B39.2 — Pulmonary histoplasmosis capsulati, unspecified (in, histoplasmosis), B44.9 — Aspergillosis, unspecified (in, aspergillosis), B49 — Unspecified mycosis, B58.3 — Pulmonary toxoplasmosis (in, toxoplasmosis), B59 — Pneumocystosis (plasma cell), +84 more

Lab tests where this diagnosis supports Medicare coverage (NCD)

Medicare's National Coverage Determination (NCD) program lists this diagnosis as medical justification for these lab tests.

HIV Screening Test

Contextual Map

Every relationship of B37.1 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Run B37.1 with these 4 related codes in Claim Check

Hierarchy

• A00-B99 — Chapter 1: Certain Infectious and Parasitic Diseases (A00-B99) (A00-B99)[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• B35-B49 — Mycoses[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026

Code Also

• J4B — Pulmonary mycetoma[Code Also]: “pulmonary mycetoma (J4B)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026

Referenced by Excludes1 notes

• J17 — Pneumonia in diseases classified elsewhere[Excludes1]: “candidial pneumonia (B37.1)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• J99 — Respiratory disorders in diseases classified elsewhere[Excludes1]: “candidiasis (B37.1)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026

Referenced by Code First instructions

• M01 — Direct infections of joint in infectious and parasitic diseases classified elsewhere[Code First](via B37.-): “mycoses (B35-B49)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026

Referenced by Code Also instructions

• J4B — Pulmonary mycetoma[Code Also]: “pulmonary candidiasis (B37.1)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026

Clinical classification (CCSR)

• RSP002 — Pneumonia (except that caused by tuberculosis)[CCSR]— AHRQ CCSR for ICD-10-CM Diagnoses (HCUP)
• INF004 — Fungal infections[CCSR]— AHRQ CCSR for ICD-10-CM Diagnoses (HCUP)

Risk adjustment (CMS-HCC)

• HCC 6 — Opportunistic Infections [CMS-HCC]— CMS-HCC V28 · 2026

MS-DRG Grouper

• MCC — Major Complication or Comorbidity [MS-DRG severity]: “As a secondary diagnosis this code can raise the stay's MS-DRG severity tier (MCC). Not counted when the stay groups to DRGs 974-976 (HIV with Major Related Condition).”— CMS MS-DRG Definitions Manual (Appendix C) · FY2026
• DRG 177 — RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC[MS-DRG]: “RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC (MDC 04)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026
• DRG 178 — RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC[MS-DRG]: “RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC (MDC 04)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026
• DRG 179 — RESPIRATORY INFECTIONS AND INFLAMMATIONS WITHOUT CC/MCC[MS-DRG]: “RESPIRATORY INFECTIONS AND INFLAMMATIONS WITHOUT CC/MCC (MDC 04)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026
• DRG 791 — PREMATURITY WITH MAJOR PROBLEMS[MS-DRG]: “PREMATURITY WITH MAJOR PROBLEMS (MDC 15)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026
• DRG 793 — FULL TERM NEONATE WITH MAJOR PROBLEMS[MS-DRG]: “FULL TERM NEONATE WITH MAJOR PROBLEMS (MDC 15)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026
• DRG 974 — HIV WITH MAJOR RELATED CONDITION WITH MCC[MS-DRG]: “HIV WITH MAJOR RELATED CONDITION WITH MCC (MDC 25)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026
• DRG 975 — HIV WITH MAJOR RELATED CONDITION WITH CC[MS-DRG]: “HIV WITH MAJOR RELATED CONDITION WITH CC (MDC 25)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026
• and 1 more

MDC crossing

• MDC 04 — Diseases and Disorders of the Respiratory System[MDC crossing]: “Diseases and Disorders of the Respiratory System — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs. 3,998 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2026
• MDC 15 — Newborns and Other Neonates with Conditions Originating in Perinatal Period[MDC crossing]: “Newborns and Other Neonates with Conditions Originating in Perinatal Period — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs.”— CMS MS-DRG Definitions Manual · FY2026

Index entries

• Bronchomycosis NOS, candidal[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
• Candidiasis, candidal, bronchitis[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
• Candidiasis, candidal, lung[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
• Candidiasis, candidal, pneumonia[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
• Candidiasis, candidal, pulmonary[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
• Pneumonia (acute) (double) (migratory) (purulent) (septic) (unresolved), Candida[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
• Pneumonia (acute) (double) (migratory) (purulent) (septic) (unresolved), in (due to), candidiasis[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026

Nearest codes (20)

• B37 — Candidiasis[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• B37.0 — Candidal stomatitis[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• B37.2 — Candidiasis of skin and nail[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• B37.3 — Candidiasis of vulva and vagina[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• B37.31 — Acute candidiasis of vulva and vagina[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• B37.32 — Chronic candidiasis of vulva and vagina[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• B37.4 — Candidiasis of other urogenital sites[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• B37.41 — Candidal cystitis and urethritis[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• and 12 more

Change history (3)

• FY2027 — Code Also note will be added[Change history]— CMS release files (code change ledger) · icd10cm-fy2027
• and 2 more

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data

CMS/CDC ICD-10-CM FY2026 tabular list, index and tables, effective October 1, 2025 Release, file and checksum · Publisher’s page

Claim edits Official source data

CMS Definitions of Medicare Code Edits — v43.1 (April 2026) Release, file and checksum · Publisher’s page

Inpatient payment groups Official source data

CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v43 Release, file and checksum · Publisher’s page

Risk adjustment Official source data

2026 Mid-Year Final ICD-10 Mappings + Model Software (cms.gov/files/zip/2026-midyear-final-icd-10-mappings.zip, 2026-midyear-final-model-software.zip) — CMS-HCC V28, PY2026 mid-year final release Release, file and checksum · Publisher’s page

Change history and date-of-service validity Official source data

CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page

Comparisons, relationships and the contextual map MedCoder structured relationship

Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears

Summary and FAQ answers MedCoder explanation

Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates

Nearest Codes in This Family

Official ICD-10-CM classifications closest to B37.1 in its code family, with their registry titles.

• B37 — Candidiasis
• B37.0 — Candidal stomatitis
• B37.2 — Candidiasis of skin and nail
• B37.3 — Candidiasis of vulva and vagina
• B37.31 — Acute candidiasis of vulva and vagina
• B37.32 — Chronic candidiasis of vulva and vagina
• B37.4 — Candidiasis of other urogenital sites
• B37.41 — Candidal cystitis and urethritis
• B37.42 — Candidal balanitis
• B37.49 — Other urogenital candidiasis

View all codes in the B37 family