icd 10 code for herpes zoster without mention of complication

by Frederik Gottlieb MD 4 min read

ICD-10 Code for Zoster without complications- B02. 9- Codify by AAPC.

What is the ICD-10 code for herpes zoster?

ICD-10 code B02 for Zoster [herpes zoster] is a medical classification as listed by WHO under the range - Certain infectious and parasitic diseases .

What is the difference between herpes zoster and disseminated zoster?

Disseminated herpes zoster is usually defined as a generalized eruption of more than 10-12 extradermatomal vesicles occurring 7-14 days after the onset of classic dermatomal herpes zoster. Typically, it is clinically indistinguishable from varicella (chickenpox).

What is the differential diagnosis of herpes zoster?

The differential diagnosis for HZ includes herpes simplex virus, impetigo, candidiasis, contact dermatitis, insect bites, autoimmune blistering disease, dermatitis herpetiformis, and drug eruptions.

What is the most common complication of herpes zoster?

Postherpetic neuralgia (PHN) is the most common complication of herpes zoster. PHN is pain that persists in the area where the rash once was for more than 90 days after rash onset. PHN can last for weeks or months, and occasionally, for years.

How do you know if herpes zoster is disseminated?

A disseminated herpes zoster infection can be diagnosed when 20 or more blisters develop systemically within a week of showing skin symptoms found in typical herpes zoster infections.

What is the difference between herpes simplex and herpes zoster?

Genital herpes is caused by herpes simplex 2. The condition we call shingles is caused by herpes zoster. Herpes zoster is the same viral infection that causes chicken pox, and the herpes zoster virus can live in the body for years after the case of chicken pox is gone, and re-emerge as the painful blisters of shingles.

What is acute herpes zoster?

Herpes zoster (shingles) is an acute, cutaneous viral infection caused by the reactivation of varicella-zoster virus (VZV), a herpesvirus that is the cause of varicella (chickenpox).

What type of infection is herpes zoster?

What is shingles? Shingles (herpes zoster) is a viral infection that causes an outbreak of a painful rash or blisters on the skin. It's caused by the varicella-zoster virus, which is the same virus that causes chickenpox. The rash most often appears as a band of rashes or blisters in one area of your body.

Can herpes be mistaken for shingles?

Shingles and herpes both cause red bumps and blisters to form on your body, but they aren't the same condition. Each condition has its own telltale signs. If you're not sure and think you might have shingles or herpes, contact a medical professional.

What are the complications from shingles?

Depending on which nerves are affected, shingles can cause an inflammation of the brain (encephalitis), facial paralysis, or hearing or balance problems. Skin infections. If shingles blisters aren't properly treated, bacterial skin infections may develop.

What causes herpes zoster?

What causes herpes zoster? Herpes zoster is caused by the reactivation of the chickenpox virus. After a person has had chickenpox, the virus lies dormant in certain nerves for many years.

What is the difference between localized and disseminated shingles?

With localized herpes zoster, the rash usually appears as a wide strip on one side of the body. With disseminated (more widespread) herpes zoster, the rash covers a wider area of the body.

Overview

  • According to the Mayo Clinic, shingles or herpes zoster is a common condition that occurs when the chicken pox virus (varicella zoster) reactivates after lying in the body dormant. The Centers for Disease Control and Prevention (CDC) estimates that one out of three people over 60 in the United States will get shingles. While the shingles rash occurs more often in older adults (50 and older)…
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Shingles (herpes zoster) refers to a painful rash caused by a reactivation of the chickenpox virus (varicella zoster). You are at greater risk for shingles if you are over the age of 60, if you had chickenpox before you were a year old or if you have a weakened immune system. Painful swelling of the lymph nodes is one of the sym…
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  • Shingles, also called herpes zoster or zoster, is a painful skin rash caused by the varicella-zoster virus, the same virus that causes chickenpox. After a person recovers from chickenpox, the virus remains inactive in the body. Usually the virus does not cause any further problems; however, the virus may re-emerge years later, causing shingles.
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Herpes zoster is the disease that occurs when a latent chickenpox infection becomes reactivated in an older adult. It is also known as shingles.
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Complications

  • Shingles in younger people who have a healthy immune system is likely to resolve without complications.Shingles in older people can also resolve without complications, although around half of those over 50 who have shingles experience continuing nerve pain called post-herpetic neuralgia (PHN).
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  • Most cases of shingles will heal on their own, with or without treatment, and won't lead to any other problems. In rare cases, shingles can lead to complications, including: 1. Ongoing pain (post-herpetic neuralgia): Damaged nerve fibers in the skin send confused messages to the brain, leading to pain that can go on for a long time after a shingles rash has disappeared. 2. Vision pr…
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  • 1. Skin complications may occur: scarring, pigmentation, secondary bacterial infection. 2. Ramsay Hunt syndrome: describes a syndrome of lesions in the ear, facial paralysis and associated hearing and vestibular symptoms. 3. Bell's palsy. 4. Rarely, meningitis, encephalitis, myelitis or hemiparesis may occur. 5. Disseminated zoster occurs mainly in immunocompromised patient…
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  • Severe cases of shingles can result in long-term nerve pain, vision loss and muscle weakness, but the most likely complication of shingles on the feet is bacterial infection. Bacterial infection occurs when the blisters are broken and become infected. Avoid wearing shoes and socks that could irritate blisters and cause skin breaks. Try to stay off your feet and keep them clean and dr…
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Signs And Symptoms

  • The clinical manifestations can be divided into the following three phases: 1. Preeruptive phase (preherpetic neuralgia) 2. Acute eruptive phase 3. Chronic phase (PHN) The preeruptive phase is characterized by the following: 1. Sensory phenomena along 1 or more skin dermatomes, lasting 1-10 days (average, 48 hours) 2. Phenomena usually are noted as pain or, less commonly, itchin…
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  • Shingles usually begins with a burning sensation, a mild itching or tingling or a shooting pain in a specific area of skin. The affected area usually is located only on one side of the chest, abdomen or face or on a portion of an arm or leg. The skin may be extremely sensitive, so that you may not be able to stand clothing touching or rubbing the area.After about five days, the skin becomes re…
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  • The pain of shingles may develop even when there is no rash. The patient may notice several days to a week of burning pain and sensitive skin before the rash appears. In this situation it may be difficult to determine the cause of the often severe pain. Just like the blisters of chickenpox, the blisters in shingles eventually burst, and the area starts to ooze. The blisters will then crust over …
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  • A shingles rash may have mild to severe pain, and the viral rash most commonly appears along a band called a dermatome. Dermatomes follow the paths of individual nerves and generally span one side of the chest, abdomen, or a limb. Unlike chicken pox, the shingles rash usually occurs on one side of the body. The shingles virus may also affect the neck, face or eyes and cause loss o…
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Treatment

  • There's no cure for shingles, but prompt treatment with prescription antiviral drugs can speed healing and reduce your risk of complications. These medications include: 1. Acyclovir (Zovirax) 2. Valacyclovir (Valtrex) Shingles can cause severe pain, so your doctor also may prescribe: 1. Capsaicin topical patch (Qutenza) 2. Anticonvulsants, such as gabapentin (Neurontin) 3. Tricycli…
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  • If your condition is diagnosed within 72 hours after the rash appears, your doctor may prescribe antiviral medication. Some antiviral medications used to treat shingles include acyclovir (Zovirax), famciclovir (Famvir) and valacyclovir (Valtrex). Antiviral medications may help to reduce the risk of developing chronic (long-lasting) pain from shingles. The skin rash and blisters should be rins…
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  • You can take steps to reduce the duration of a shingles outbreak, but in the end, the virus must often simply run its course. There is no cure for shingles. Antiviral medication is effective only if given early, so it is important to visit your doctor soon after an outbreak starts or is suspected Those with facial, nose, or eye symptoms should seek medical care immediately. Early medical …
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  • Ask your doctor if youd benefit from a shingles vaccine. The vaccines are available in physicians offices and pharmacies.
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Causes

  • Shingles is caused by the same virus that causes chickenpox (varicella-zoster virus or VZV), a member of the herpes family of viruses. After a person has chickenpox, the virus can live dormant in the nervous system for life. Sometimes the virus remains dormant forever, but in other cases, the virus reactivates along a nerve of sensation. Shingles is contagious. Shingles can be spread …
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  • Shingles rash is caused by the varicella zoster virus, the same virus that causes chicken pox. The shingles virus lies dormant in the nerve fibers of people who have had chicken pox; as they age, the virus can reactivate and cause shingles. The CDC reports that about one in five people who have had chicken pox will get this viral rash at some point in their lives. It is most common in tho…
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  • Diseases that weaken your immune system such as cancer, HIV/AIDS can increase the risk that patients will suffer a shingles outbreak. Because cancer treatments will significantly weaken the immune system, those that have gone through chemotherapy or radiation are also at a higher risk for developing singles. Any other medications that suppress the immune system such as those …
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  • After an outbreak of chickenpox, usually in childhood, the virus that causes it stays in your body, lying dormant in certain nerve cells. Although your immune system usually keeps the virus in check, anything that affects the immune system's ability to hold back the virus -- illnesses, immunosuppressive drugs, severe stress, or aging-related changes, for example -- can allow the …
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Prevention

  • A vaccine called Zostavax is recommended for people 60 and over to help prevent shingles and to decrease the risk of post-herpetic neuralgia if shingles does occur. It is also approved for people 50 and over. The vaccine is given once. The ingredients in the vaccine are the same as the chickenpox vaccine for children, but the dose is 14 times stronger.In a large study, patients who …
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  • Wearing loose clothing can help avoid extra pain from clothing rubbing against the rash. Avoid close skin-to-skin contact with others who have not had chickenpox, are ill, or who have a weakened immune system to avoid spread of the virus. In May 2006, the U.S. Food and Drug Administration (FDA) approved the first vaccine for adult shingles. The vaccine is known as Zost…
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  • According to the CDC, more than 99 percent of Americans age 40 and older have had chicken pox. If you dont know if you had chicken pox, check with your family doctor who can review your records. Also talk with your doctor about a shingles vaccination to prevent this viral rash if you have the following shingles virus risk factors: Two vaccines may help prevent the shingles virus …
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  • Shingles vaccination is one of the recommended vaccinations for older people. There is a vaccine available for adults aged 50 years or older, called Zostavax, that can help prevent shingles and its complications. While being vaccinated cannot guarantee that you won’t get shingles, it does reduce the probability. Among those who do get shingles despite being immunised, the vaccine …
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Diagnosis

  • Shingles is usually diagnosed based on the history of pain on one side of your body, along with the telltale rash and blisters. Your doctor may also take a tissue scraping or culture of the blisters for examination in the laboratory.
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  • Diagnosis is based primarily on the history and physical findings. In most cases, confirming the diagnosis via laboratory testing has no utility. In select patient populations, however—particularly immunocompromised patients—the presentation can be atypical and may require additional testing.Laboratory studies for VZV include the following: 1. Direct fluorescent antibody (DFA) tes…
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  • Shingles can be difficult to diagnose before visible signs of the disease appear. Once a rash and blisters appear, your doctor probably will diagnose shingles based on your symptoms and the appearance of your skin. Rarely, when the diagnosis is less certain, the doctor may scrape tissue, collect cells from the affected skin and examine them under a microscope for cellular changes c…
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  • The clinical appearance of shingles is usually sufficient for a doctor to establish the diagnosis. Diagnostic tests are not usually required. However, particularly in people with impaired immune function, shingles may sometimes not have the characteristic clinical pattern. In this situation, samples from the affected skin may be examined in a laboratory, either by culturing the tissue fo…
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Prognosis

  • Most people recover completely from an acute episode with no pain; and skin color returns to normal. Once you have had shingles, it is unusual for the condition to return. Shingles comes back in only about 2% of people, but in up to 20% of people with AIDS. Long-term complications from shingles, such as post-herpetic neuralgia, may continue for months or many years. The disease …
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  • Postherpetic neuralgia (PHN) is the most common complication of shingles. This is defined as persistence of the nerve pain associated with shingles beyond one month, even after the rash is gone. It occurs from irritation of the sensory nerves by the virus. The pain of PHN can be severe and debilitating. Up to 15% of people with shingles develop PHN. Typically, this occurs in people …
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  • If you had chickenpox as a child, you will never contract it as an adult. But that doesn't mean you won't have to deal with shingles, which is caused by the highly contagious varicella-zoster virus, the same one responsible for chickenpox. Shingles, which affects an estimated one in five people, is a painful, blistering condition. It can show up at any time, but is especially alarming if it strike…
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  • 1. The prognosis for younger and otherwise healthy patients is excellent. 2. Pregnant women and immunosuppressed patients have the highest risk of serious sequelae. 3. Elderly people have a significantly increased risk of complications, including PHN, bacterial infections and scarring. 4. Immune compromise carries poorer prognosis. 5. Mortality is rare. Disseminated disease in the …
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Epidemiology

  • Shingles is most common in people over 60 years of age, although anyone who has ever had chickenpox is at risk. Up to 1,000,000 cases of shingles are estimated to occur each year in the U.S.
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  • The risk of developing shingles also becomes greater as people age. People over the age of 50 are significantly more likely to develop shingles than any other age group. It is estimated that about half the people who live to age 85 will experience shingles at least once.
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Chickenpox is a very common childhood illness. At least 90% of adults raised in the UK are immune, having been exposed in childhood.All these people are therefore at risk of developing shingles. Shingles is seen as a disease of older people but it can affect all ages, including children. The incidence and severity increase with age. T…
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  • The risk of developing postherpetic neuralgia increases with age. The condition is much more common in people 60 and older than in younger people with shingles. The area affected also makes a difference. When shingles occurs on the face, as in your case, the likelihood of postherpetic neuralgia is significantly higher than for other parts of the body.
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Risks

  • A more worrisome complication occurs when shingles affects the face (forehead and nose), which may spread to the eye and lead to loss of vision.
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  • Not all essential oils are safe for every person, though. Some people report a burning sensation where they apply capsaicin, and allergic reactions to different plants are common. Check with your doctor first to make sure you're a good candidate for this supplemental treatment.
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