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    v1.0.28
    OpenPayerBilling CodesProtozoal diseasesICD-10-CM b54-unspecified-malaria
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    ICD-10-CM Code For Unspecified Malaria: Group Overview

    The International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) code group B54 includes diagnoses for malaria when the infecting Plasmodium species is not specified or documented and covers systemic protozoal infections presenting with febrile illness and possible organ involvement. These ICD-10-CM diagnosis codes are used to document clinical encounters involving confirmed or suspected malaria without species identification, capturing factors such as severity, complications like anemia, or multisystem involvement. Accurate coding within the ICD-10-CM B54 group supports proper claim adjudication, complete clinical documentation, and appropriate reimbursement.

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    ICD-10-CM B54: Unspecified Malaria Overview

    The ICD-10-CM B54 group represents diagnoses for malaria cases where the specific Plasmodium species is not identified. These conditions target systemic protozoal infection affecting multiple organ systems, often presenting with fever, chills, and hematologic abnormalities. Accurate coding is important for correct clinical records and can affect reimbursement by reflecting the infection's presence and severity.

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    When to Use

    Use a code from this group when a diagnosis of malaria is recorded but the infecting species is not documented or cannot be determined. Codes in this group apply to clinical encounters where malaria is confirmed or strongly suspected but species identification is unavailable.

    ICD-10-CM Codes

    1 rows

    ICD-10-CM CodeDescription
    B54Unspecified malaria

    DRG Codes

    3 rows

    DRG CodeDescription
    867Other Infectious and Parasitic Diseases Diagnoses with MCC
    868Other Infectious and Parasitic Diseases Diagnoses with CC
    869Other Infectious and Parasitic Diseases Diagnoses without CC/MCC

    Typical Clinical Scenarios

    • A traveler returns from sub-Saharan Africa with several days of high fever, chills, headache, myalgias, and malaise; rapid diagnostic tests and thick/thin smears are inconclusive or unavailable, and clinicians document malaria without species identification, so an unspecified malaria diagnosis is assigned. Typical codes: B54.
    • An elderly nursing home resident develops acute fever, altered mental status, and anemia after recent hospital transfer from a long-term care facility; initial workup supports malaria but species testing cannot be completed due to hemolyzed specimens, leading to coding of malaria, unspecified. Typical codes: B54.
    • A patient with a history of treated malaria presents for follow-up with persistent intermittent fevers and nonspecific constitutional symptoms but prior records lack definitive species documentation; because current notes confirm malaria as the cause of symptoms without species confirmation, an unspecified malaria code is used as a comorbidity contributing to the current clinical picture. Typical codes: B54.

    Related Codes

    B50-PLASMODIUM-FALCIPARUM-MALARIA

    ICD-10-CM Code For Plasmodium Falciparum Malaria: Group Overview

    B52-PLASMODIUM-MALARIAE-MALARIA

    ICD-10-CM Code For Plasmodium Malariae Malaria: Group Overview

    B53-OTHER-SPECIFIED-MALARIA

    ICD-10-CM Code For Other Specified Malaria: Group Overview

    B55-LEISHMANIASIS

    ICD-10-CM Code For Leishmaniasis: Group Overview

    B56-AFRICAN-TRYPANOSOMIASIS

    ICD-10-CM Code For African Trypanosomiasis: Group Overview

    B57-CHAGAS-DISEASE

    ICD-10-CM Code For Chagas' Disease: Group Overview

    B58-TOXOPLASMOSIS

    ICD-10-CM Code For Toxoplasmosis: Group Overview

    B59-PNEUMOCYSTOSIS

    ICD-10-CM Code For Pneumocystosis: Group Overview

    B60-OTHER-PROTOZOAL-DISEASES

    ICD-10-CM Code For Other Protozoal Diseases Not Elsewhere Classified: Group Overview

    B64-UNSPECIFIED-PROTOZOAL-DISEASE

    ICD-10-CM Code For Unspecified Protozoal Disease: Group Overview

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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