ICD-10 Coding for Acquired Immunodeficiency Syndrome(B20, Z21)
Complete ICD-10-CM coding and documentation guide for Acquired Immunodeficiency Syndrome. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Acquired Immunodeficiency Syndrome
B20Primary Range
HIV disease resulting in infectious and parasitic diseases
Primary code for active AIDS diagnosis, used when HIV-related conditions are present.
Asymptomatic human immunodeficiency virus [HIV] infection status
Used for patients with HIV infection without symptoms or history of AIDS-defining conditions.
Human immunodeficiency virus [HIV] disease complicating pregnancy, childbirth and the puerperium
Used for pregnant patients with HIV, indicating the need for additional codes to specify HIV status.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| B20 | Human immunodeficiency virus [HIV] disease | Use when the patient has an AIDS diagnosis or HIV-related conditions. |
|
| Z21 | Asymptomatic human immunodeficiency virus [HIV] infection status | Use when the patient is HIV positive without symptoms or history of AIDS. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for acquired immunodeficiency syndrome
Essential facts and insights about Acquired Immunodeficiency Syndrome
Primary ICD-10-CM Codes for acquired immunodeficiency syndrome
Decision Criteria
clinical Criteria
- Presence of AIDS-defining conditions or low CD4 count
Applicable To
- AIDS
- AIDS-related complex
- HIV infection, symptomatic
Excludes
- Asymptomatic HIV infection status (Z21)
Z21 - Asymptomatic human immunodeficiency virus [HIV] infection status
Use when the patient is HIV positive without symptoms or history of AIDS.
Applicable To
- HIV positive NOS
Excludes
- AIDS (B20)
Clinical Validation Requirements
- No history of AIDS-defining conditions
- No current symptoms related to HIV
Coding Notes
Z21 should not be used if the patient has ever had an AIDS-defining condition.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Acquired Immunodeficiency Syndrome to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code B20.
Impact
Clinical: Potential mismanagement of patient care., Regulatory: Non-compliance with coding standards., Financial: Loss of reimbursement due to incorrect coding.
Mitigation Strategy
Ensure all conditions are evaluated for potential HIV linkage., Regular training on documentation standards.
Impact
Reimbursement: Incorrect coding can lead to improper DRG assignment., Compliance: Non-compliance with ICD-10 coding guidelines., Data Quality: Inaccurate patient records and risk adjustment scores.
Mitigation Strategy
Always use B20 if the patient has a history of AIDS-defining conditions.
Impact
Using Z21 for patients with a history of AIDS-defining conditions.
Mitigation Strategy
Implement regular audits and training on HIV coding guidelines.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Acquired Immunodeficiency Syndrome, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Acquired Immunodeficiency Syndrome
Use these documentation templates to ensure complete and accurate documentation for Acquired Immunodeficiency Syndrome. These templates include all required elements for proper coding and billing.
Infectious Disease Progress Note
Specialty: Infectious DiseaseRequired Elements
- HIV Status
- Last CD4/VL
- Active OIs
- ART Regimen
- AIDS-defining Condition
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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