ICD-10 B58.81
Billable / Specific MCCToxoplasma myocarditis
About ICD-10-CM B58.81
ICD-10-CM code B58.81 represents Toxoplasma myocarditis. This is a billable/specific code in the Infectious and Parasitic Diseases chapter (block B58). The 2026 edition of ICD-10-CM B58.81 became effective on October 1, 2025.
Coding Tips for B58.81
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
B58.81 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 Toxoplasma myocarditis. As a Major Complication/Comorbidity (MCC), this can shift the DRG assignment to a higher-weighted category, substantial reimbursement impact.
Medicare LCD Coverage for B58.81
Local Coverage Determinations (LCDs) from CMS MACs that list B58.81 as a covered diagnosis.
Showing top 10 of 95 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing B58.81.
2 Cigna
4 Medicare
2 Aetna
CPT Codes Commonly Billed with B58.81
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
- 93319 CMS LCD: Billing and Coding: Echocardiography CMS LCD
- 93307 CMS LCD: Billing and Coding: Echocardiography CMS LCD
- 93351 CMS LCD: Billing and Coding: Echocardiography CMS LCD
- 93355 CMS LCD: Billing and Coding: Echocardiography CMS LCD
- J1250 CMS LCD: Billing and Coding: Echocardiography CMS LCD
- 93304 CMS LCD: Billing and Coding: Echocardiography CMS LCD
- 93352 CMS LCD: Billing and Coding: Echocardiography CMS LCD
- J0280 CMS LCD: Billing and Coding: Echocardiography CMS LCD
- 93318 CMS LCD: Billing and Coding: Echocardiography CMS LCD
- 93308 CMS LCD: Billing and Coding: Echocardiography CMS LCD
Convert B58.81 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 |
|---|---|---|
| B58.81 | 1303 | 00000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To B58.81
Other codes in section B50-B64 (Protozoal diseases).
ICD-10 B58.81, Billing FAQ
Is ICD-10 code B58.81 billable? +
Yes, B58.81 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
Is B58.81 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 B58.81? +
Procedures frequently paired with B58.81 include: 93319, 93307, 93351, 93355, J1250.
What ICD-9 codes does B58.81 map to? +
Per CMS GEMs, B58.81 maps to ICD-9 codes: 1303. 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 July 17, 2026.
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