Pulmonary mecetoma occurs most commonly in association with cavitaintg lung diseases like tuberculosis, abscess, CA, HIV infection and the most affending organism is Aspergillus species.
Cavitating diseases: large cavitating –TB, Abscesses, carcinomas, and small cavitating diseases
are rheumatoid nodules, squamous or transitional cell mets, wegners Granulomatosis etc.
Peumonias cavitating are Staph, strep, Tb gram negative (klebsiella).
Cavities containing masses are Aspergillosis, cavitating bronchogenic Ca, Tuberculosis, Hydatid Cyst.
If any one of these is documented which could produce cavitation in the lungs, with mycetoma then , I think a code from 480-519 should also be assigned along with the 117.x code, until proven otherwise by culture and immuno-diagnostic methods.