ICD 10 Guidelines for HIV

[RU4NU22406]

Hi,

I need a little bit of clarification with the HIV Guidelines:

For the B20 code to me that is ONLY used when the patient is admitted to the hospital. But is the B20 code used when the patient goes to see there physician. Example:

Patient goes to see there physician for a fever but is also HIV positive. You would code the sinus infection first and then B20 for the HIV positive or is there a code that I am missing, or not seeing for the HIV positive dx when a patient goes to see there physician.

I appreciate any feedback as I am very confused on this B20 code.

Thanks,

Kim

 

[Alicia Scott]

Let's look at B20
B20 - Human immunodeficiency virus [HIV] disease
Includes:
acquired immune deficiency syndrome [AIDS]
AIDS-related complex [ARC]
HIV infection, symptomatic

Code First:
Human immunodeficiency virus [HIV] disease complicating pregnancy, childbirth and the puerperium, if applicable (O98.7-)

Use additionalcode(s) to identify all manifestations of HIV infection

Excludes1:
asymptomatic human immunodeficiency virus [HIV] infection status (Z21)
exposure to HIV virus (Z20.6)
inconclusive serologic evidence of HIV (R75)

This code means a person has AIDS. You would code it when ever the patient is seen by a provider. Unlike
Z21 - Asymptomatic human immunodeficiency virus [HIV] infection status
HIV positive NOS

You might find reason to not code a Z21.

Here are the official guidelines for HIV codes
2) Selection and sequencing of HIV codes

(a) Patient admitted for HIV-related condition
If a patient is admitted for an HIV-related condition, the principal diagnosis should be B20, Human immunodeficiency virus [HIV] disease followed by additional diagnosis codes for all reported HIV-related conditions.

(b) Patient with HIV disease admitted for unrelated condition
If a patient with HIV disease is admitted for an unrelated condition (such as a traumatic injury), the code for the unrelated condition (e.g., the nature of injury code) should be the principal diagnosis. Other diagnoses would be B20 followed by additional diagnosis codes for all reported HIV-related conditions.

(f) Previously diagnosed HIV-related illness
Patients with any known prior diagnosis of an HIV-related illness should be coded to B20. Once a patient has developed an HIV-related illness, the patient should always be assigned code B20 on every subsequent admission/encounter. Patients previously CD-10-CM Official Guidelines for Coding and Reporting 2013 Page 18 of 113 diagnosed with any HIV illness (B20) should never be assigned to R75 or Z21, Asymptomatic human immunodeficiency virus [HIV] infection status.