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B20 - Human immunodeficiency virus [HIV] disease

ICD-10-CM Chapter 1: Certain infectious and parasitic diseases · B20 Human immunodeficiency virus [HIV] disease (B20) · Top-level category · FY2027

Includes, Excludes and Coding Notes

IncludesFrom B20

Conditions this code covers.

  • acquired immune deficiency syndrome [AIDS]
  • AIDS-related complex [ARC]
  • HIV infection, symptomatic
Excludes 1 — Not Coded HereFrom B20

Mutually exclusive: these conditions are never reported together with this code.

  • asymptomatic human immunodeficiency virus [HIV] infection status (Z21)
  • exposure to HIV virus (Z20.6)
  • inconclusive serologic evidence of HIV (R75)
Use Additional CodeFrom B20

Add a secondary code to identify the associated condition or cause when it is documented.

  • code(s) to identify all manifestations of HIV infection
Code FirstFrom B20

Sequence the underlying condition before this code.

  • Human immunodeficiency virus [HIV] disease complicating pregnancy, childbirth and the puerperium, if applicable (O98.7-)
IncludesFrom Chapter A00-B99

Conditions this code covers.

  • diseases generally recognized as communicable or transmissible
Excludes 2 — Not Included HereFrom Chapter A00-B99

Not part of this code; report both codes when the patient has both conditions.

  • carrier or suspected carrier of infectious disease (Z22.-)
  • certain localized infections - see body system-related chapters
  • infectious and parasitic diseases complicating pregnancy, childbirth and the puerperium (O98.-)
  • infectious and parasitic diseases specific to the perinatal period (P35-P39)
  • influenza and other acute respiratory infections (J00-J22)
Use Additional CodeFrom Chapter A00-B99

Add a secondary code to identify the associated condition or cause when it is documented.

  • code to identify resistance to antimicrobial drugs (Z16.-)

Inpatient DRG Payments

DRG 9742,609 discharges

Hiv With Major Related Condition With Mcc

Avg. Medicare Payment

$29,027

Total Payment$33,402
Patient Responsibility$4,375
Hospital Charge$149,750
DRG 975954 discharges

Hiv With Major Related Condition With Cc

Avg. Medicare Payment

$13,978

Total Payment$17,230
Patient Responsibility$3,252
Hospital Charge$68,377

Related condition guides

Documentation requirements, coding pitfalls and FAQs for conditions coded with B20.