ICD-10 B01.2
Billable / Specific MCCVaricella pneumonia
About ICD-10-CM B01.2
ICD-10-CM code B01.2 represents Varicella pneumonia. This is a billable/specific code in the Infectious and Parasitic Diseases chapter (block B01). The 2026 edition of ICD-10-CM B01.2 became effective on October 1, 2025.
Coding Tips for B01.2
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
B01.2 is designated MCC for MS-DRG grouping. On inpatient claims, this code can shift the DRG to the with-MCC variant when documented as a present-on-admission secondary diagnosis. Hospital CDI programs flag MCC opportunities during chart review. Failure to capture this code may leave 30 to 80 percent of the inpatient stay revenue unrealized.
Inpatient DRG Impact, MCC
codes Varicella pneumonia. As a Major Complication/Comorbidity (MCC), this can shift the DRG assignment to a higher-weighted category, substantial reimbursement impact.
Medicare LCD Coverage for B01.2
Local Coverage Determinations (LCDs) from CMS MACs that list B01.2 as a covered diagnosis.
Showing top 10 of 73 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing B01.2.
3 Medicare
CPT Codes Commonly Billed with B01.2
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
- 94726 CMS LCD: Billing and Coding: Respiratory Therapy (Respiratory Care) CMS LCD
- 94004 CMS LCD: Billing and Coding: Respiratory Therapy (Respiratory Care) CMS LCD
- 94621 CMS LCD: Billing and Coding: Respiratory Therapy (Respiratory Care) CMS LCD
- 94011 CMS LCD: Billing and Coding: Respiratory Therapy (Respiratory Care) CMS LCD
- 94003 CMS LCD: Billing and Coding: Respiratory Therapy (Respiratory Care) CMS LCD
- 94668 CMS LCD: Billing and Coding: Respiratory Therapy (Respiratory Care) CMS LCD
- 94070 CMS LCD: Billing and Coding: Respiratory Therapy (Respiratory Care) CMS LCD
- 94664 CMS LCD: Billing and Coding: Respiratory Therapy (Respiratory Care) CMS LCD
- 94012 CMS LCD: Billing and Coding: Respiratory Therapy (Respiratory Care) CMS LCD
- 31502 CMS LCD: Billing and Coding: Respiratory Therapy (Respiratory Care) CMS LCD
Convert B01.2 to ICD-9-CM
Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.
| ICD-10 | ICD-9 | Mapping Flags |
|---|---|---|
| B01.2 | 0521 | 00000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To B01.2
Other codes in section B00-B09 (Viral infections characterized by skin and mucous membrane lesions).
ICD-10 B01.2, Billing FAQ
Is ICD-10 code B01.2 billable? +
Yes, B01.2 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
Is B01.2 a CC or MCC for inpatient DRG? +
Yes, this code is designated as MCC. Documenting as a secondary diagnosis on inpatient claims can shift the DRG to a higher-weighted category.
What CPT codes are commonly billed with B01.2? +
Procedures frequently paired with B01.2 include: 94726, 94004, 94621, 94011, 94003.
What ICD-9 codes does B01.2 map to? +
Per CMS GEMs, B01.2 maps to ICD-9 codes: 0521. Useful for legacy data review and historical claim analysis.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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