Infectious mononucleosis, unspecified without complication

This code represents a diagnosis of infectious mononucleosis, commonly known as mono, where the specific type or causative agent is not documented. It indicates an acute viral infection, typically caused by the Epstein-Barr virus (EBV), characterized by symptoms such as fatigue, fever, sore throat, and swollen lymph nodes. This code is used when no complications of the infection are present or documented.

Use this code when the medical record clearly states a diagnosis of infectious mononucleosis but does not specify the type (e.g., EBV, CMV) and there are no documented complications. This is appropriate for initial encounters or follow-up visits where the primary diagnosis remains uncomplicated mono. Documentation should confirm the diagnosis and absence of any associated complications.

• Do not use if a specific type of infectious mononucleosis (e.g., due to EBV) is documented; use the more specific code.
• Ensure the medical record explicitly states "without complication" or that no complications are noted to justify this code.
• If complications such as splenic rupture, hepatitis, or neurological involvement are present, a more specific code reflecting the complication should be used, often in conjunction with the primary mono code.