Coding spotlight: HIV and AIDS
HIV-related condition | ICD-10-CM code |
Pneumonia, unspecified organism | J18.9 |
Tuberculosis of other sites | A18.89 |
Sepsis, unspecified organism | A41.9 |
Candida stomatitis (thrush) | B37.0 |
Human immunodeficiency virus [HIV] disease. 2016 2017 2018 2019 2020 2021 2022 Billable/Specific Code. B20 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM B20 became effective …
Oct 01, 2016 · Asymptomatic human immunodeficiency virus [HIV] infection status. 2016 2017 2018 2019 2020 2021 2022 Billable/Specific Code Questionable As Admission Dx. Z21 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement …
7 rows · Mar 01, 2020 · HIV-related condition. ICD-10-CM code. Pneumonia, unspecified organism. J18.9. ...
ICD-10-CM Official Guidelines for Coding and Reporting . FY 2018 (October 1, 2017 - September 30, 2018) 1. Chapter 1: Certain Infectious and Parasitic Diseases (A00-B99) a. Human …
The code title indicates that it is a manifestation code. "In diseases classified elsewhere" codes are never permitted to be used as first listed or principle diagnosis codes. They must be used in conjunction with an underlying condition code and they must be listed following the underlying condition.
Clinical Information. Development of neutralizing antibodies in individuals who have been exposed to the human immunodeficiency virus (hiv/htlv-iii/lav). Infected with the human immunodeficiency virus (hiv), the cause of acquired immunodeficiency syndrome (aids).
In most cases the manifestation codes will have in the code title, "in diseases classified elsewhere.". Codes with this title are a component of the etiology/manifestation convention. The code title indicates that it is a manifestation code.
Previously diagnosed HIV-related illness. Code B20 if you document a patient as having had any known prior diagnosis of an HIV-related illness – Z21 is no longer reported. If the patient develops an HIV-related illness, they should be assigned code B20 on every subsequent admission/encounter.
HIV infection in pregnancy, childbirth and the puerperium. Assign code O98.7 – Human immunodeficiency virus [HIV] disease complicating pregnancy, childbirth and the puerperium first when a patient presents for treatment of an HIV-related illness during pregnancy, childbirth or the puerperium followed by code B20.
Code B20 if you document a patient as having had any known prior diagnosis of an HIV-related illness – Z21 is no longer reported. If the patient develops an HIV-related illness, they should be assigned code B20 on every subsequent admission/encounter. HIV infection in pregnancy, childbirth and the puerperium.
The conventions for the ICD-10-CM are the general rules for use of the classification independent of the guidelines. These conventions are incorporated within the Alphabetic Index and Tabular List of the ICD-10-CM as instructional notes.
The ICD-10-CM has two types of excludes notes. Each type of note has a different definition for use but they are all similar in that they indicate that codes excluded from each other are independent of each other.
NEC “Not elsewhere classifiable” This abbreviation in the Alphabetic Index represents “other specified.”When a specific code is not available for a condition, the Alphabetic Index directs the coder to the “other specified” code in the Tabular List.
“code also” note instructs that two codes may be required to fully describe a condition, but this note does not provide sequencing direction. The sequencing depends on the circumstances of the encounter.
The assignment of a diagnosis code is based on the provider’s diagnostic statement that the condition exists. The provider’s statement that the patient has a particular condition is sufficient. Code assignment is not based on clinical criteria used by the provider to establish the diagnosis.
sequela is the residual effect (condition produced) after the acute phase of an illness or injury has terminated. There is no time limit on when a sequela code can be used. The residual may be apparent early, such as in cerebral infarction, or it may occur months or years later, such as that due to a previous injury. Examples of sequela include: scar formation resulting from a burn, deviated septum due to a nasal fracture, and infertility due to tubal occlusion from old tuberculosis. Coding of sequela generally requires two codes sequenced in the following order: the condition or nature of the sequela is sequenced first. The sequela code is sequenced second.
Code assignment is based on the provider’s documentation of the relationship between the condition and the care or procedure, unless otherwise instructed by the classification. The guideline extends to any complications of care, regardless of the chapter the code is located in. It is important to note that not all conditions that occur during or following medical care or surgery are classified as complications. There must be a cause-and-effect relationship between the care provided and the condition, and an indication in the documentation that it is a complication. Query the provider for clarification, if the complication is not clearly documented.