B54 — Unspecified malaria
Is B54 billable?
Yes, but B54 is an unspecified code. B54 is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, B54 is an unspecified or catch-all code. Payers apply additional scrutiny to unspecified codes and many deny them when the medical record supports a more specific option, so check the documentation before selecting B54.
B54 at a glance
| Code | B54 |
|---|---|
| Description | Unspecified malaria |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
Which MS-DRGs does B54 group to?
B54 sits in MDC 18 and helps define the logic of 3 MS-DRGs (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.
- 867Other Infectious and Parasitic Diseases Diagnoses with MCCmedical
- 868Other Infectious and Parasitic Diseases Diagnoses with CCmedical
- 869Other Infectious and Parasitic Diseases Diagnoses without CC/MCCmedical
As a secondary diagnosis, B54 is a complication or comorbidity (CC), which can move a stay into a higher-paying DRG.
How is B54 listed in the Alphabetic Index?
These are the routes through the Alphabetic Index that lead to B54. They show the wording a clinician may have documented, which often differs from the Tabular description.
- Malaria, malarial (fever)
- Remittent fever (malarial)
- Anemia › malarial (essential) (general) (hemoglobin deficiency) (infantile) (primary) (profound)
- Anemia › marsh (essential) (general) (hemoglobin deficiency) (infantile) (primary) (profound)
- Anemia › paludal (essential) (general) (hemoglobin deficiency) (infantile) (primary) (profound)
- Chill › congestive in malarial regions (s)
- Malaria, malarial › clinically diagnosed (fever)
- Malaria, malarial › congestion, congestive (fever)
- Malaria, malarial › hemorrhagic (fever)
- Malaria, malarial › recurrent (fever)
- Malaria, malarial › remittent (fever)
- Malaria, malarial › spleen (fever)
Excludes1 — never code together — inherited from B50-B64
The conditions below can never be reported together with B54 on the same claim. An Excludes1 note means the two conditions cannot occur in the same patient, so reporting both is a coding error.
Use additional code — inherited from Chapter 1
Report an additional code alongside B54 to fully describe the condition. B54 is sequenced first.
- code to identify resistance to antimicrobial drugs (Z16.-)
Excludes2 — not included here — inherited from Chapter 1
The conditions below are not part of B54, but a patient may have both at the same time. When documentation supports it, B54 and the excluded code may both 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)
How long has B54 existed?
B54 has been in ICD-10-CM since at least FY2016, the earliest fiscal year on record here.
Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.