ICD-10 Coding for Herpes Virus Infection(B00.1, B00.2)
Complete ICD-10-CM coding and documentation guide for Herpes Virus Infection. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Herpes Virus Infection
B00Primary Range
Herpesviral [herpes simplex] infections
This range covers all herpes simplex virus infections, including various manifestations such as vesicular dermatitis, gingivostomatitis, and ocular disease.
Anogenital herpesviral [herpes simplex] infections
This range is specific to anogenital herpes infections, which are excluded from the B00 range.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| B00.1 | Herpesviral vesicular dermatitis | Use when herpes simplex virus causes vesicular lesions on the skin, such as cold sores. |
|
| B00.2 | Herpesviral gingivostomatitis and pharyngotonsillitis | Use for herpes simplex infections affecting the oral cavity, such as gingivostomatitis. |
|
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 virus infection
Essential facts and insights about Herpes Virus Infection
Primary ICD-10-CM Codes for herpes virus infection
Decision Criteria
clinical Criteria
- Presence of vesicular lesions confirmed by lab tests
Applicable To
- Herpes labialis
- Cold sores
Excludes
- Anogenital herpes (A60.-)
Clinical Validation Requirements
- Presence of grouped vesicles on an erythematous base
- Positive HSV PCR or culture
Code-Specific Risks
- Misclassification with herpes zoster
- Use of unspecified codes when specific site is documented
Coding Notes
- Ensure documentation specifies the location and type of HSV infection to avoid unspecified coding.
B00.2 - Herpesviral gingivostomatitis and pharyngotonsillitis
Use for herpes simplex infections affecting the oral cavity, such as gingivostomatitis.
Applicable To
- Herpes simplex gingivostomatitis
Excludes
- Anogenital herpes (A60.-)
Clinical Validation Requirements
- Oral lesions with vesicular appearance
- Positive HSV PCR from oral swab
Coding Notes
Document the presence of oral vesicular lesions and confirm with lab tests to ensure accurate coding.
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 Virus Infection to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code B00.1.
Impact
Clinical: May lead to inappropriate treatment, Regulatory: Non-compliance with coding standards, Financial: Potential for denied claims
Mitigation Strategy
Always confirm HSV type with lab tests, Include type in documentation
Impact
Reimbursement: May lead to lower reimbursement due to unspecified coding, Compliance: Non-compliance with coding guidelines, Data Quality: Decreases accuracy of health data
Mitigation Strategy
Ensure documentation specifies the exact location and type of HSV infection.
Impact
High risk of audits when unspecified codes are used without justification
Mitigation Strategy
Ensure documentation is detailed and supports 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 Virus Infection, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Herpes Virus Infection
Use these documentation templates to ensure complete and accurate documentation for Herpes Virus Infection. These templates include all required elements for proper coding and billing.
Dermatology consultation for herpes labialis
Specialty: DermatologyRequired Elements
- Location of lesions
- Description of vesicles
- Lab test results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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