Tinea unguium
Chapter 1:Certain infectious and parasitic diseases
ICD-10 B36.3 is a billable code used to indicate a diagnosis of tinea unguium.
Tinea unguium, also known as onychomycosis, is a fungal infection that affects the nails, primarily the toenails, but can also involve fingernails. It is characterized by nail discoloration, thickening, and potential separation from the nail bed. The condition is often caused by dermatophytes, but non-dermatophyte molds and yeasts can also be responsible. Risk factors include advanced age, diabetes mellitus, immunocompromised states, and poor circulation. Patients may experience discomfort, pain, and cosmetic concerns due to the appearance of the affected nails. Diagnosis is typically made through clinical examination and may be confirmed with laboratory tests such as nail clippings or scrapings sent for fungal culture or microscopy. Treatment options include topical antifungal agents, such as ciclopirox and efinaconazole, and systemic antifungal medications like terbinafine and itraconazole. The choice of treatment often depends on the severity of the infection, the patient's overall health, and any underlying conditions that may affect treatment efficacy.
Detailed clinical notes on nail examination, treatment plans, and follow-up assessments.
Patients presenting with nail discoloration, thickening, or pain; recurrent infections; and treatment failures.
Consideration of patient history, including previous treatments and response, is crucial for accurate coding.
Comprehensive foot examinations, including vascular and neurological assessments, and documentation of any underlying conditions.
Patients with diabetes presenting with nail infections, athletes with fungal infections, and elderly patients with nail dystrophies.
Podiatrists must document the impact of the infection on mobility and overall foot health.
Used when significant nail dystrophy is present and requires removal of infected nail material.
Document the extent of debridement and the condition of the nail bed.
Podiatrists may perform this procedure more frequently in diabetic patients.
Tinea unguium is primarily caused by dermatophyte fungi, but can also be due to non-dermatophyte molds and yeasts.
Diagnosis is made through clinical examination and can be confirmed with laboratory tests such as nail clippings or cultures.
Treatment options include topical antifungals like ciclopirox and systemic antifungals such as terbinafine and itraconazole, depending on the severity of the infection.
