Video: Hiv Icd 10 Cm Codes When To Use Z Code Vs B Code
It was funny because when we were looking at our answer sheets earlier today, Alicia goes, I love this little timeline thing, how do you get that? I said, The CDC website because thats actually where this came from. What I did is, if you didnt know this, the Federal government, our Federal government here in the United States has a website devoted to AIDS and HIV because for years it was so rampant and its still a very large thing that we have to deal with.
They actually estimate that up to 18% of the population that has HIV has no idea that they have HIV because theyre asymptomatic. What they explained is that there are really three stages of HIV. Theres the Acute Infection point where the person first gets infected and their body, its a virus so its replicating constantly. Thats that acute infection timeframe. Usually, they might have some flu-like symptoms. Its going to be a bad flu, its not going to be, Oh, that was a piece of cake. Thats kind of all the more theyre going to get. Theyre not going to know. Its not going to be any abnormal, crazy, Oh, I must have HIV, thats what this is.
When we talk about symptoms related to their HIV, CDC actually defines AIDS, their CD4 cells fall below 200 cells and thats when its progressed to AIDS. They actually go up to explain that its not just the CD4 blood counts, its actually about whether or not a patient has had what we call an OI or an opportunistic infection.
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If Sepsis Developed Solely After Inpatient Admission U071 Could Also Meet The Criteria For Principal Diagnosis If That Was The Reason For Admission
A version of this article was first published July 17, 2020, by HCPro’s Revenue Cycle Advisor, a sibling publication to HealthLeaders.
Q: We have a patient that was admitted with sepsis due to novel coronavirus who also has human immunodeficiency virus . How should we report this in ICD-10-CM, and which MS-DRG would this be assigned to?
A: Patients with HIV are more susceptible to being infected by COVD-19 due to being immune compromised, HIV does not cause COVID-19. The sequencing would be based on the circumstances of the admission.
The specific MS-DRG assignment would be determined by whether or not the provider documents the sepsis as an HIV-related illness. Sepsis is identified as an HIV-related illness however, coders cannot assume a linkage between the two conditions.
Per Coding Clinic, First Quarter 2019, provider documentation must specifically indicate that the patient has an HIV-related illness prior to the assignment of ICD-10-CM code B20 .
Coding Clinic went on to say that it would not be appropriate to automatically link a diagnosis as an HIV-related condition based solely on the Centers for Disease Control and Preventions AIDS-Defining Illnesses list and/or conditions included in major diagnostic category 25 . If the documentation is unclear or ambiguous regarding the patients HIV status, the provider should be queried.
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Info For Medical Coders On How To Properly Use This Icd
- Code Includes Notes: Includes notes further define, or give examples of, conditions included in the section.
- Acquired immune deficiency syndrome
- AIDS-related complex
- HIV infection, symptomatic
- codeFirst:
- Human immunodeficiency virus disease complicating pregnancy, childbirth and the puerperium, if applicable See code O98.7-
- Additional Code Note:
Use Additional Code
Use Additional Code note means a second code must be used in conjunction with this code. Codes with this note are Etiology codes and must be followed by a Manifestation code or codes.
- Code to identify all manifestations of HIV infection
- Code Type-1 Excludes:
Type-1 Excludes
Type-1 Excludes mean the conditions excluded are mutually exclusive and should never be coded together. Excludes 1 means “do not code here.”
- Inconclusive serologic evidence of HIV – instead, use Code R75
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Human Immunodeficiency Virus Disease
- 2016201720182019202020212022Billable/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 on October 1, 2021.
- This is the American ICD-10-CM version of B20 – other international versions of ICD-10 B20 may differ.
“use additional code”
- code to identify all manifestations of HIV infection
“code first”
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The Icd Code B20 Is Used To Code Hiv/aids
Human immunodeficiency virus infection and acquired immune deficiency syndrome is a spectrum of conditions caused by infection with the human immunodeficiency virus . Following initial infection, a person may not notice any symptoms or may experience a brief period of influenza-like illness. Typically, this is followed by a prolonged period with no symptoms. As the infection progresses, it interferes more with the immune system, increasing the susceptibility to common infections like tuberculosis, as well as other opportunistic infections, and tumors that rarely affect people who have working immune systems. These late symptoms of infection are referred to as AIDS. This stage is often also associated with weight loss.
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Certain Infectious And Parasitic Diseasesincludes
- certain localized infections – see body system-related chapters
- carrier or suspected carrier of infectious disease
- infectious and parasitic diseases complicating pregnancy, childbirth and the puerperium
- infectious and parasitic diseases specific to the perinatal period
- influenza and other acute respiratory infections
- code to identify resistance to antimicrobial drugs
- Acquired immune deficiency syndrome in childbirth
- Acquired immune deficiency syndrome postpartum
- Acquired immune deficiency syndrome with pregnancy
- Acquired immune deficiency syndrome-related nephropathy
- Aids
- Aids with neuropathy
- Aids with polyneuropathy
- Aids, cdc stage a3
- Cognitive impairment due to human immunodeficiency virus infection
- Dementia associated with aids
- Hiv cdc category a3
- Hiv cdc category b3
- Hiv cdc category c1
- Hiv cdc category c2
- Hiv cdc category c3
- Hiv in pregnancy
- Hiv related non hodgkins lymphoma
- Hiv1 infection, symptomatic
- Lipoatrophy due to hiv infection and treatment
- Myelitis due to hiv
- Neuropathy due to human immunodeficiency virus
- Non-hodgkin lymphoma associated with human immunodeficiency virus infection
- Polyneuropathy associated with aids
- Symptomatic human immunodeficiency virus 1 infection
- Symptomatic human immunodeficiency virus infection category b1
- Symptomatic human immunodeficiency virus infection category b2
- Symptomatic human immunodeficiency virus infection
- : New code
- 2017
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Q& a: Using Codes Z21 And B20 For Hiv Patients
Sharme Brodie, RN, CCDS,answered this question.
Q: I have a question about coding human immunodeficiency virus and HIV-related illnesses. If a physician documents a patient is HIV positive, should the chart be coded to Z21? What about if they document the patient is HIV positive with an HIV-related illnesswould that be coded to B20?
A: You are correct. The ICD-10-CM Official Guidelines for Coding and Reporting, Section I.C.1.a.2.f. says that patients who are HIV positive with any known prior diagnosis of an HIV related illness should be coded to code B20. Only confirmed cases are coded using code B20. HIV is one of three conditions that cannot be coded based on the documented terminology, possible, probable, or suspected, or any other similar terminology.
It is not required that any form of testing be documented, such as a positive serology test. The physicians diagnostic statement that the patient is HIV positive with a prior HIV-related condition is all that is necessary for coding. Once a patient is coded to B20, they will always have B20 coded on their record they will never go back to being coded using the asymptomatic code Z21.
Editors Note: Sharme Brodie, RN, CCDS, CDI education specialist and CDI Boot Camp instructor for HCPro in Middleton, Massachusetts, answered this question. For information, contact her at . For information regarding CDI Boot Camps, .
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Asymptomatic Human Immunodeficiency Virus Infection Status
- 2016201720182019202020212022Billable/Specific CodeQuestionable As Admission Dx
- Human immunodeficiency virus disease complicating pregnancy, childbirth and the puerperium, if applicable
- contact with human immunodeficiency virus
- exposure to human immunodeficiency virus
- human immunodeficiency virus disease
- inconclusive laboratory evidence of human immunodeficiency virus
Update To Hiv Coding In 2022
Changes to ICD-10-CM coding are effective October 1. The 2022 changes are effective October 1, 2021, even though we call them the 2022 year codes and changes. This year, there is a new guideline for coding HIV/AIDS when the patient is on an anti-retroviral drug. This is from the Official Guidelines.
History of HIV managed by medication
If a patient with documented history of HIV disease is currently managed on antiretroviral medications, assign code B20, Human immunodeficiency virus disease. Code Z79.899, Other long term drug therapy, may be assigned as an additional code to identify the long-term use of antiretroviral medications.
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Hiv Icd 10 Cm Codes When To Use Z Code Vs B Code
Q: HIV ICD 10 CM Codes On the HIV codes, when do you use the Z code versus the B code? Would you code the patient as being active if they have history of HIV?
A: When we start looking at the AIDS and HIV codes, we originally received this question that came asking, When do we use that Z code versus when do we use the 042 in ICD-9? So we went update it for ICD-10.
Im reiterating some of the information that Tammy and Alicia covered when they covered this topic back in August, but I looked at it from a little bit different perspective. Youll find Im huge on citing my sources, so I wanted to give you where I found the information that helped me make my decision in when do I use the Z code, the Z21 versus the B20.
When we first start looking at HIV, the important thing to understand here is that a patient at this point in time cannot have a history of HIV, its not possible. We do not yet have a cure for HIV. Once the patient has HIV, they have HIV for life. From a coding perspective, it simplybecomes do they have symptomatic HIV or do they have asymptomatic HIV?
Well scroll down a little bit farther and were going to talk about how do we figure out what constitutes asymptomatic, which is the Z21, versus what constitutes symptomatic, which is B20.
Advice For Coding And Documenting Hiv
National HIV Testing Day is June 27.
Wednesday is National HIV Testing Daya day designated to highlight the importance of testing in detecting, treating, and preventing human immunodeficiency virus infection.
This special day is designed to encourage people to get tested for HIV, know their status, and get linked to care and treatment if they have HIV. This years theme, Doing It My Way, Testing for HIV, reminds us that each person has his or her own reasons why they test for HIV, and their own unique ways of doing so.
About 1.1 million people in the United States have HIV, and one in seven of them dont know it. Many people have HIV for years before they get a diagnosis. For those living with undiagnosed HIV, testing is the first step in maintaining a healthy life and reducing HIV transmission. Thus, awareness of HIV infection through HIV testing is the first step to social services that improve life quality and length of survival.
The Centers for Disease Control and Prevention recommend to healthcare providers that they:
- Routinely provide HIV testing to all people ages 13 to 64, in accordance with CDC guidelines.
- Screen all teens and adults for HIV risk and test people at high risk at least once a year. This includes some gay and bisexual men who may benefit from more frequent testing .
- Start people on HIV treatment as quickly as possible after diagnosis.
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