ICD-10 Coding for AIDS(B20, Z21)
Complete ICD-10-CM coding and documentation guide for AIDS. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to AIDS
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 symptomatic HIV/AIDS or an AIDS-defining illness. |
|
| Z21 | Asymptomatic human immunodeficiency virus [HIV] infection status | Use for patients who are HIV+ but asymptomatic. |
|
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 AIDS
Essential facts and insights about AIDS
Primary ICD-10-CM Codes for aids
Decision Criteria
clinical Criteria
- Presence of AIDS-defining illness or CD4 count <200 cells/μL.
documentation Criteria
- Physician documentation of symptomatic HIV or AIDS-related condition.
Applicable To
- AIDS
- HIV disease resulting in other conditions
Excludes
- Asymptomatic HIV infection status (Z21)
Z21 - Asymptomatic human immunodeficiency virus [HIV] infection status
Use for patients who are HIV+ but asymptomatic.
Applicable To
- HIV positive without symptoms
Excludes
- AIDS (B20)
Clinical Validation Requirements
- HIV positive status without symptoms or AIDS-defining conditions.
Coding Notes
Do not use Z21 if the patient has ever been diagnosed with AIDS.
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 AIDS to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code B20.
Impact
Clinical: Leads to incorrect treatment plans., Regulatory: Non-compliance with coding standards., Financial: Potential loss of reimbursement.
Mitigation Strategy
Ensure clear documentation of all related conditions., Use specific phrases like 'due to AIDS'.
Impact
Reimbursement: Incorrect coding can lead to improper reimbursement., Compliance: Non-compliance with ICD-10 guidelines., Data Quality: Inaccurate patient records and data reporting.
Mitigation Strategy
Always use B20 for patients with a history of AIDS.
Impact
Using Z21 for patients with a history of AIDS.
Mitigation Strategy
Regular training on ICD-10 guidelines for HIV/AIDS coding.
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 AIDS, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for AIDS
Use these documentation templates to ensure complete and accurate documentation for AIDS. These templates include all required elements for proper coding and billing.
Infectious Disease Progress Note
Specialty: Infectious DiseaseRequired Elements
- HIV Status
- CD4/VL
- AIDS-Defining Conditions
- ART Regimen
- Active Symptoms
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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