Clinical Context
Scabies is a parasitic skin infestation caused by Sarcoptes scabiei that presents primarily with pruritus, which may take several weeks to develop in first-time infestations but can occur within 24 hours in reinfestations 3. The condition is recognized as a neglected tropical disease by the World Health Organization and has shown increasing prevalence in recent years, including in developed countries 1, 4, 5.
Diagnostic Coding
- B86 is the single, specific ICD-10 code used for all scabies diagnoses in both outpatient and inpatient settings 1, 2
- This code applies to both uncomplicated scabies and crusted (Norwegian) scabies variants 1
- The code is used regardless of whether the diagnosis is confirmed by clinical examination, dermoscopy, or microscopy 2
Important Clinical Considerations
- Scabies in adults is frequently sexually acquired, though in children it typically is not 3
- The diagnosis should ideally be confirmed by dermoscopy or microscopy, particularly after 14 days of treatment, to avoid false-positive cases based solely on clinical examination 2
- Pruritus may persist for up to 2 weeks after successful treatment, which does not indicate treatment failure 3, 6
Documentation Requirements
- When coding B86, ensure documentation includes the characteristic pruritic presentation and, when possible, confirmation of mite identification 7, 2
- For crusted scabies in immunocompromised patients (including those with HIV, organ transplant recipients, or those on systemic glucocorticoids), the same B86 code applies, though additional codes for the underlying condition should be included 3