ICD-10-CM diagnosis coding for positive HIV status

Following ICD-10 guidelines, a patient with HIV status without symptoms is coded with Z21, positive HIV status. October3,2022Inthispost ICD-10-CMdiagnosiscodingforpositiveHIVstatus UpdatetoHIVcodingin2022 MedicalpracticereimbursementforindividualclaimsbasedonCPT® Riskadjustedfactorforcodingmedicalclaims HCCModel CommonHIVdiagnosiscodes ICD-10generalguidelines Question:  ForanHIVpositivepatientwithoutsymptoms,isthecorrectdiagnosiscodeZ21orB20? Whatdifferencedoesitmaketoreimbursement? Answer:  FollowingICD-10guidelines,apatientwithHIVstatuswithoutsymptomsiscodedwithZ21,positiveHIVstatus. Somedoctorsandnon-physicianpractitionerswouldprefertouseB20.AccordingtoICD-10,B20isusedwhenthepatienthasconfirmedAIDS. FollowingICD-10guidelines,ifapatienthasorhashadanHIVrelatedcondition,useB20AIDS. IfthepatienthasapositiveHIVstatus,withoutsymptomsorrelatedconditions,useZ21. SeetheexcerptsfromtheICD-10-CMGeneralGuidelines,below. UpdatetoHIVcodingin2022 ChangestoICD-10-CMcodingareeffectiveOctober1.The2022changesareeffectiveOctober1,2021,eventhoughwecallthemthe2022yearcodesandchanges.Thisyear,thereisanewguidelineforcodingHIV/AIDSwhenthepatientisonananti-retroviraldrug.ThisisfromtheOfficialGuidelines. (i)HistoryofHIVmanagedbymedication IfapatientwithdocumentedhistoryofHIVdiseaseiscurrentlymanagedonantiretroviralmedications,assigncodeB20,Humanimmunodeficiencyvirus[HIV]disease.CodeZ79.899,Otherlongterm(current)drugtherapy,maybeassignedasanadditionalcodetoidentifythelong-term(current)useofantiretroviralmedications. ApatientwithknownHIVwhoistakingantiretroviralmedicationsisnowcodewithB20,notZ21.Logintoreadtherestofthisarticle Don’thavealogin?Becomeamember,orlearnmoreaboutthebenefitsofmembershipbyclickingonthelinkbelow. GetUnlimitedAccesstoCodingIntel’sOnlineLibrary Areyouacoder,biller,administrator,officemanagerorphysician? LearnmoreaboutthebenefitsofaCodingIntelmembership clickhere! LastrevisedOctober26,2021-BetsyNicolettiTags:HCCdiagnosiscoding Howdocoderstelltime? Learnwhetheranhouris31minutesor60minuteswhenselectingaCPT®code.SubscriberstoourmonthlynewsletterreceiveaccesstoBetsy'svideoandreferencesheet,"Astimegoesby"thatprovideanswerstothisquestion. SignUpNow RecommendedResource You’vecodedit,butyoustillhavetofighttogetpaid!We’vepartneredwithElizabethWoodcocktogiveyouthetoolsandstrategiesyouneed. Findthemhere! LatestIntel ICD-10-CM:2023CodingandReporting…ReadMore...Oneofthecomplexitiesformedicalpracticesis…ReadMore...Question:IbelievethatIknowtheanswertothis…ReadMore...2023E/Mguidelinesforhospital,nursing…ReadMore... BrowseByCategories BrowseByCategories SelectCategory Topic    Caremanagementandremotemonitoring    DiagnosisCoding    E/Mchanges    Howphysicianservicesarepaid    InpersonE/M    Newandnewsworthy    Preventionandscreening    Specialtypages    Surgicalprocedures,modifiers,globalpackage TypeofContent    Articles    Blog    CanIGetPaidto    CodingGuides    EverydayCoding    EverydayCodingQ&A    QuickReferenceSheets    Videos    Webinars Uncategorized    Free    Premium BrowseContent Tags behavioralhealth_cptcodes behavioralhealth_E/Mservices caremanagement categoryofservice CMSupdates Codesetsandreimbursement complianceissues CPTcodesforpreventiveservices CPTupdates criticalcareservices dermatology_E/Mservices dermatology_essentialresource dermatology_procedures E/Mfrequencydata E/Mmedicaldecisionmaking E/Moverview E/Mreferencesheets E/Mrulechanges FQHC generalsurgery_diagnosiscoding generalsurgery_E/Mservices generalsurgery_modifiers generalsurgery_procedures globalsurgeryissues HCCdiagnosiscoding ICD-10coding levelofservice_MDM levelofservice_time medicareincident-toandsharedservices minorprocedures modifiers otherE/Mservices Preventiveandproblemvisits preventiveservicesformedicare primarycare_diagnosiscoding primarycare_E/Mservices primarycare_essentialresource primarycare_modifiers primarycare_otherE/Mservices primarycare_preventiveservices primarycare_procedures remotephysiologicmonitoring screeningandcounselingforbehavioralconditions teachingphysicianrules telehealth AllcontentonCodingInteliscopyrightprotected.Anyresourcesharedwithinthepermissionsgrantedheremaynotbealteredinanyway,andshouldretainallcopyrightinformationandlogos. Ourmissionistoprovideup-to-date,simplified,citationdrivenresourcesthatempowerourmemberstogainconfidenceandauthorityintheircodingrole. In1988,CodingIntel.comfounderBetsyNicolettistartedaMedicalServicesOrganizationforaruralhospital,supportingphysicianpractice.Shehasbeenaself-employedconsultantsince1998.Sheestimatesthatinthelast20yearsheraudiencemembersnumberover28,400atinpersoneventsandwebinars.Shehashad2,500meetingswithclinicalprovidersandreviewedover43,000medicalnotes.Sheknowswhatquestionsneedanswersanddevelopedthisresourcetoanswerthosequestions.FormoreaboutBetsyvisitwww.betsynicoletti.com.