ICD-10 Coding for Herpes Simplex Virus(B00.0, B00.1)
Complete ICD-10-CM coding and documentation guide for Herpes Simplex Virus. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Herpes Simplex Virus
B00.0-B00.9Primary Range
Herpesviral [herpes simplex] infections
This range covers all herpes simplex virus infections, including dermatitis, stomatitis, and encephalitis.
Anogenital herpesviral [herpes simplex] infections
This range is specific to anogenital herpes infections, which are a common manifestation of HSV.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| B00.0 | Herpesviral vesicular dermatitis | Use when documenting vesicular skin lesions caused by HSV. |
|
| B00.1 | Herpesviral vesicular stomatitis | Use for oral lesions caused by HSV. |
|
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 herpes simplex virus
Essential facts and insights about Herpes Simplex Virus
Primary ICD-10-CM Codes for herpes simplex virus
Decision Criteria
clinical Criteria
- Presence of vesicular lesions confirmed by lab tests
Applicable To
- Herpes simplex dermatitis
Excludes
- Herpes zoster (B02.-)
Clinical Validation Requirements
- Presence of vesicular lesions confirmed by PCR or viral culture
Code-Specific Risks
- Misclassification with herpes zoster
Coding Notes
- Ensure documentation specifies HSV type and lesion location.
B00.1 - Herpesviral vesicular stomatitis
Use for oral lesions caused by HSV.
Applicable To
- Herpes simplex stomatitis
Excludes
- Herpangina (B08.5)
Clinical Validation Requirements
- Oral lesions confirmed by PCR or viral culture
Coding Notes
Document specific location and type of oral lesions.
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 Herpes Simplex Virus to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code B00.0.
Impact
Clinical: May lead to inappropriate treatment., Regulatory: Fails to meet documentation standards., Financial: Potential for denied claims.
Mitigation Strategy
Always specify HSV-1 or HSV-2, Include diagnostic test results
Impact
Reimbursement: May lead to lower reimbursement rates., Compliance: Non-compliance with coding guidelines., Data Quality: Decreases the accuracy of health records.
Mitigation Strategy
Always specify the type and location of HSV infection.
Impact
Using unspecified codes can trigger audits.
Mitigation Strategy
Ensure detailed documentation and specific 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 Herpes Simplex Virus, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Herpes Simplex Virus
Use these documentation templates to ensure complete and accurate documentation for Herpes Simplex Virus. These templates include all required elements for proper coding and billing.
HSV Oral Lesions
Specialty: DentistryRequired Elements
- Location of lesions
- Type of lesions
- Diagnostic method
- HSV type
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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