ICD-10 Coding for Herpes(B00.0, A60.0)
Complete ICD-10-CM coding and documentation guide for Herpes. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Herpes
B00-B09Primary Range
Viral infections characterized by skin and mucous membrane lesions
This range includes herpes simplex and herpes zoster infections, which are the primary focus for herpes-related conditions.
Anogenital herpesviral infections
This range specifically addresses genital herpes, a common manifestation of herpes simplex virus.
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 vesicular lesions are confirmed to be caused by herpes simplex virus. |
|
| A60.0 | Anogenital herpesviral infection | Use for confirmed cases of genital herpes. |
|
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
Essential facts and insights about Herpes
Primary ICD-10-CM Codes for herpes
Decision Criteria
clinical Criteria
- Vesicular lesions with positive HSV test
Applicable To
- Herpes simplex dermatitis
- Herpes simplex skin infection
Excludes
- Herpes zoster (B02.-)
Clinical Validation Requirements
- Presence of vesicular lesions
- Positive HSV PCR or culture
Code-Specific Risks
- Misclassification if not confirmed by lab tests
Coding Notes
- Ensure documentation specifies the site and type of herpes infection.
A60.0 - Anogenital herpesviral infection
Use for confirmed cases of genital herpes.
Applicable To
- Genital herpes
- Herpes simplex of genitalia
Excludes
- Herpes simplex of other sites (B00.-)
Clinical Validation Requirements
- Genital lesions
- Positive HSV-2 PCR
Coding Notes
Document specific site and confirm with lab results.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Herpes to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code B00.0.
Impact
Clinical: Leads to inappropriate treatment plans., Regulatory: Increases risk of audit findings., Financial: May result in claim denials.
Mitigation Strategy
Always document the exact location of lesions., Use templates to ensure completeness.
Impact
Reimbursement: May lead to claim denials or reduced reimbursement., Compliance: Increases risk of audit and non-compliance., Data Quality: Affects accuracy of health records.
Mitigation Strategy
Ensure documentation specifies the site and type of herpes infection.
Impact
High audit risk when using codes like B00.9 without specificity.
Mitigation Strategy
Ensure documentation supports the most specific code available.
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, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Herpes
Use these documentation templates to ensure complete and accurate documentation for Herpes. These templates include all required elements for proper coding and billing.
Genital herpes outbreak
Specialty: DermatologyRequired Elements
- History of present illness
- Physical examination findings
- Laboratory results
- Assessment and plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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