ICD-10 B51.0
Billable / Specific CCPlasmodium vivax malaria with rupture of spleen
About ICD-10-CM B51.0
ICD-10-CM code B51.0 represents Plasmodium vivax malaria with rupture of spleen. This is a billable/specific code in the Infectious and Parasitic Diseases chapter (block B51). The 2026 edition of ICD-10-CM B51.0 became effective on October 1, 2025.
Coding Tips for B51.0
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
B51.0 is designated CC for MS-DRG grouping. On inpatient claims, this code can shift the DRG to the with-CC variant when documented as a present-on-admission secondary diagnosis. Hospital CDI programs flag CC opportunities during chart review. Failure to capture this code may leave 30 to 80 percent of the inpatient stay revenue unrealized.
Inpatient DRG Impact, CC
codes Plasmodium vivax malaria with rupture of spleen. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.
Medicare LCD Coverage for B51.0
Local Coverage Determinations (LCDs) from CMS MACs that list B51.0 as a covered diagnosis.
Showing top 10 of 129 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing B51.0.
1 Cigna
3 Medicare
CPT Codes Commonly Billed with B51.0
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
- 0031U CMS LCD: Billing and Coding: Pharmacogenomics Testing CMS LCD
- 0173U CMS LCD: Billing and Coding: Pharmacogenomics Testing CMS LCD
- 0423U CMS LCD: Billing and Coding: Pharmacogenomics Testing CMS LCD
- 81407 CMS LCD: Billing and Coding: Pharmacogenomics Testing CMS LCD
- 0349U CMS LCD: Billing and Coding: Pharmacogenomics Testing CMS LCD
- 81408 CMS LCD: Billing and Coding: Pharmacogenomics Testing CMS LCD
- 0175U CMS LCD: Billing and Coding: Pharmacogenomics Testing CMS LCD
- 0032U CMS LCD: Billing and Coding: Pharmacogenomics Testing CMS LCD
- 81220 CMS LCD: Billing and Coding: Pharmacogenomics Testing CMS LCD
- 0392U CMS LCD: Billing and Coding: Pharmacogenomics Testing CMS LCD
Convert B51.0 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 |
|---|---|---|
| B51.0 | 0849 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To B51.0
Other codes in section B50-B64 (Protozoal diseases).
ICD-10 B51.0, Billing FAQ
Is ICD-10 code B51.0 billable? +
Yes, B51.0 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
Is B51.0 a CC or MCC for inpatient DRG? +
Yes, this code is designated as CC. Documenting as a secondary diagnosis on inpatient claims can shift the DRG to a higher-weighted category.
What CPT codes are commonly billed with B51.0? +
Procedures frequently paired with B51.0 include: 0031U, 0173U, 0423U, 81407, 0349U.
What ICD-9 codes does B51.0 map to? +
Per CMS GEMs, B51.0 maps to ICD-9 codes: 0849. 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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