Hello Medico Pediaa, Today i will explain about HIV AIDS Realted Guidelines in ICD 10 in very easy language , so that you can code easily with the help of this guidelines. AIDS guidelines in ICD 10 is very important guidelines for live coding and in this article we clear your doubt related to Sepsis , HIV , Zika Virus and Covid . HIV AIDS Related Guidelines is started with A00 to B99 , For Example if a patients has Confirmed Case of AIDS then B20 coded for his Confirmed Case.

Let’s Start HIV AIDS Related Guidelines in ICD 10————————————————————

What is HIV ?

Human immunodeficiency virus is a virus that attacks cells that help the body fight infection.

There is no cure but it is treatable with medicine.

Where did HIV come from?

HIV infection in humans came from a type of chimpanzee in Central Africa. Studies show that HIV may have jumped from chimpanzees to humans as far back as the late 1800s.
The chimpanzee version of the virus is called simian immunodeficiency virus. It was probably passed to humans when humans hunted these chimpanzees for meat and came in contact with their infected blood.

What are the stages of HIV?

Stage 1: Acute HIV infection

People have a large amount of HIV in their blood and are very contagious.
Many people have flu-like symptoms.
If you have flu-like symptoms and think you may have been exposed to HIV, get tested.

Stage2: Chronic HIV infection

People may not have any symptoms or get sick during this phase but can transmit HIV.
People who take HIV treatment as prescribed may never move into Stage 3 (AIDS).
Without HIV treatment, this stage may last a decade or longer, or may progress faster.

Stage 3: Acquired immunodeficiency syndrome (AIDS)

The most severe stage of HIV infection.
People with AIDS have badly damaged immune systems. They can get an increasing number of opportunistic infections or other serious illnesses.
Without HIV treatment, people with AIDS typically survive about three years.

What is the ICD-10-CM guidelines for HIV/AIDS ?

HIV/ AIDS related Guidelines

What is the confirmed cases of HIV in ICD -10 ?

B20 is AIDS code, when HIV virus is activated in patients body and causing some abnormalities then principle diagnosis should be B20 followed by additional diagnosis code.

Selection and sequencing of HIV codes.

Patient admitted for HIV related conditions:

If patient is admitted HIV related conditions then principal diagnosis is B20 followed by additional diagnosis code is HIV related conditions.

Principal diagnosis – B20(HIV)

Secondary diagnosis – HIV related conditions

HIV related conditions: Dementia,cancer, pneumonia, sarcoma, cardidasis etc.

Note : An exception for this guidelines is If the patient is admitted for hemolytic uremia syndrome associated with HIV disease then assign code D59.311( infection associated hemolytic uremic syndrome followed by code B20(HIV).

Patient with HIV disease admitted for unrelated conditions:

If patient with HIV disease and admitted for unrelated conditions (such as trauma or burn and injury) then code unrelated conditions as principal diagnosis and other diagnosis should be B20.

Principal diagnosis – HIV unrelated conditions (trauma, injury, burn)

Secondary diagnosis – B20

Whether the patient is newly diagnosed:

Whether the patient is newly diagnosed or has had previous admission/ encounters for HIV conditions is irrelevant to the sequencing decision.

What is the ICD -10 code for Asymptomatic HIV ?

Z21 Asymptomatic Human immunodeficiency virus(HIV) infection status.

While Z21 is status of HIV present code which says virus is present in patients body, but doesn’t activated or not causing any harm .

Patient with inconclusive HIV serology:

Assign R75 inconclusive laboratory evidence of HIV for patients with inconclusive HIV serology for patient without definitive diagnosis or manifestation of the illness.

Previously diagnosed HIV-related illness:

If ever B20 is being coded for patient we cannot code Z21 ever for him/her means if virus has been activated in past it will be active forever. Patient previously diagnosed with an HIV illness (B20) should never be assigned to R75 or Z21 asymptomatic HIV infection status.

HIV infection in pregnancy, childbirth and the puerperium:

During pregnancy, childbirth or the puerperium patient admitted to the hospital because of HIV-related illness then code O98.7– HIV disease complicating pregnancy childbirth and the puerperium as principal diagnosis followed by B20 and the codes for HIV related illness.

Patient admitted with asymptomatic HIV infection status during pregnancy childbirth and puerperium should code O98.7– principal diagnosis and Z21 as a secondary diagnosis.

1. Encounters for test for HIV/ what is the ICD -10 code for rule out of HIV?

Patient is coming lab test then code Z11.4 (HIV screening code)

If result is negative and physician is giving counseling then need to counseling code Z71.7.

If patient returns to be informed of HIV test and result is negative then assign Z71.7 code.

2. HIV managed by antiretroviral medication:

If patient with documented HIV disease, HIV related illness or AIDS is currently managed on antiretroviral medication then assign B20 HIV disease code and Z79.899 (other long term current drug therapy may be assigned as an additional diagnosis.

ICD-10-CM Conventions Guidlines 2024 : – https://medicopediaa.com/icd-10-cm-conventions-guidlines-2024/

SEPSIS GUIDELINES ICD 10 CM

What is the sepsis guidelines in ICD -10 ?

Coding of Sepsis and Severe sepsis

For a diagnosis of Sepsis assign the appropriate code for the underlying systemic infection.

If the type of infection or causal organism is not further specified assign code A41.9 sepsis, unspecified organism.

Note: A code from subcategory R65.2 severe sepsis should not be assigned unless severe sepsis should not be assigned unless severe sepsis or an associated acute organ dysfunction documented.

Sepsis – A41.9

Severe sepsis – A41.9, 6520, any organ failure.

Negative or inconclusive blood culture and sepsis and urosepsis

Negative or inconclusive blood culture do not preclude a diagram of sepsis in patient with clinical evidence of the condition however the provider should be queried.

Urosepsis

Term urosepsis is a nonspecific term.
It is not to be considered synonymous with sepsis.
It has no default code in Alphabetic index, should provider use this term, he/she must be queried for clarification.

Sepsis with Organ dysfunction

If a patient has sepsis and associated acute organ dysfunction or multiple organ dysfunction follow the instruction for coding severe sepsis.

Acute organ dysfunction that is not clearly associated with sepsis

If a patient has sepsis and an acute organ dysfunction, but the medical record documentation indicates that the acute organ dysfunction a related to medical condition other than the sepsis do not assign a code from subcategory R65.2, severe sepsis.

An acute organ dysfunction must be associated with the sepsis in order to assign the severe sepsis code.

If the documentation is not clear as to whether an acute organ dysfunction is related to the sepsis or another medical condition query the provider.

What is the ICD -10 code for Severe sepsis ?

The coding of severe sepsis requires a minimum of 2 code, first a code for the underlying systemic infection, followed by a code from subcategory R65.2 severe sepsis.

If the causal organism is not documented assign code A41.9 sepsis unspecified organism for the infection. Additional codes for the associated acute organ dysfunction are also required.

Severe sepsis – underlying systemic infection (A41.9) , severe sepsis (R65.2), any associated organ failure.

What is the ICD -10 code for Septic shock ?

Septic shock generally refers to circulatory failure associated with Severe sepsis and therefore, it represents a type of acute organ dysfunction.

For cases of septic shock sequencing is code for systemic infection as principal diagnosis followed by code R65.21 as septic shock

Septic shock – A41.9 + R65.21

In case of post procedural septic shock sequencing is code for systemic infection A41.9 as principal diagnosis followed by T81.12 post procedural septic shock as additional diagnosis.

Post procedural septic shock – A41.9 + T81.12

Note: sequencing instructions in the tabular list code for septic shock cannot be assigned as a principal diagnosis.

Sequencing

Severe sepsis is present on admission then sepsis A41.9 as principal diagnosis and code for severe sepsis R65.21 as additional diagnosis.
Not present on admission but develops during the encounter then primary diagnosis will be reason for encounter + systemic infection and severe sepsis should be coded as second diagnosis .

Sepsis and severe sepsis with a localised infection:

Both sepsis and localised infection like pneumonia or are reason for encounter then code sepsis as primary diagnosis, code for localised infection and code for severe sepsis.

Note: Patient admitted for localised infection and sepsis doesn’t develop after admission then localised infection should be coded as primary diagnosis, sepsis and severe sepsis code as secondary diagnosis.

Sepsis due to a post procedural infection

If a post procedural infection has resulted in post procedural septic shock assign the codes indicated above for sepsis due to a post procedural infection followed by code T81.12- Post procedural septic shock.

Don’t assign R65.21, Severe sepsis with septic shock .

Additional codes should be assigned for acute organ dysfunction.

What is the ICD -10 code for Hemolytic uremic syndrome associated with sepsis?

If the patient is admitted for hemolytic uremic syndrome associated with sepsis then assign code D59.31, infection associated hemolytic uremic syndrome as a principal diagnosis, and other conditions such as severe sepsis should be assign as secondary diagnosis.

Methicillin Resistant staphylococcus aureus (MRSA) condition:

What is the Selection and sequencing of MRSA code in ICD-10 ?

Combination for MRSA infection:

Sepsis with MRSA – A41.02 ( sepsis due to MRSA)

Pneumonia with MRSA – J15.212

Puerperal sepsis (6 weeks of pregnancy) – O85 ( puerperal sepsis, severe sepsis R65.2 don’t code from A40 and A41.

Other codes for MRSA infection:

MRSA code is B95.62
Current condition due to MRSA (for e.g. wound infection, stitch abscess, UTI) – code current condition first , then code B85.62 code.

MSSA( Methicillin suspectible staphylococcus aureus and MRSA colonization:

Sepsis with MSSA – A41.01
MSSA only – B95.61
MSSA (for e.g. wound infection, stitch abscess, UTI) – code current condition first, B95.61.

colonization means that MSSA or MRSA is present on or in the body without necessarily causing illness. A positive MRSA colonization test might be documented by the provider as “MRSA screen positive” or “MRSA nasal swab positive.

Assign code Z22.322, carrier or suspected carrier of MRSA, for patient documented as having MRSA colonization.

Assign code Z22.321, carrier or suspected carrier of Methicillin suspectible staphylococcus aureus,for patient documented as having MSSA colonization.

MRSA colonization and infection

If a patient is documented as having both MRSA colonization and infection during a hospital admission code Z22.32, carrier or suspected carrier of Methicillin resistant staphylococcus aureus and a code for the MRSA infection may both assigned.

What is the ICD -10 code for Zika virus infection ?

Code only confirmed cases

Code only confirmed diagnosis of Zika virus (A92.5)

If provider documents “suspected” possible Zika virus, Don’t code A92.5, code only Z20.821(contact with and suspected exposure to Zika virus).

What is the ICD-10-CM code Corona virus infection ?

What is the confirmed casesof COVID-19 in ICD-10 ? :

For a confirmed diagnosis, assign code U07.1.

For suspectible or possible or inconclusive cases, assign code Z20.828 don’t assign U07.1 for such cases.

Sequencing of codes

When COVID -19 meets the definition of principal diagnosis code U07.1 should be sequences first, followed by appropriate codes for associated manifestation, except in the case of obstetrics patient .

What is the ICD-10 code for Pneumonia due to COVID -19?

For a pneumonia case confirmed as due to COVID-19 assign codes U07.1 and J12.89.

What is the Acute bronchitis due to COVID -19 in ICD-10-CM?

for a patient with acute bronchitis confirmed as due to COVID -19 assign code U07.1 and J20.8.

Bronchitis not otherwise specified (NOS) due to COVID -19 should be coded using code U07.1 and J40.

What is the Lower respiratory infection due to COVID -19 in ICD-10-CM?

If the COVID -19 is documented as being associated with a lower respiratory infection (NOS) or an acute respiratory infection (NOS) code U07.1 and J22.

If the COVID – 19 is documented as being associated with a respiratory infection NOS codes U07.1 and J98.8.

What is the ICD -10 code for ARDS due to COVID -19 ?

For acute respiratory distress syndrome due to COVID -19 assign code U07.1 and J80.

What is the ICD -10 code for Exposure to COVID -19?

For cases where there is a concern about a possible exposure to COVID -19 , but this is ruled out after evaluation , assign code Z03.818.

For cases where there is an actual exposure to COVID -19 but this is ruled out after evaluation , assign code Z03.818.

For cases where there is an actual exposure to someone who is confirmed or suspected to have COVID – 19 and the exposed individual either test negative or the test results are unknown assign code Z20.828.

What is the ICD -10 code for Screening for COVID-19 ?

For asymptomatic individuals who are being screened to the viruses and the test result are either unknown or -ve , assign code Z11.59.

Signs/symptoms without definitive diagnosis of COVID -19

For patients presenting with any signs , symptom associated with COVID -19 ( such as fever, cough etc) but a definitive diagnosis has not been established assign the appropriate codes for each of the presenting signs and Symptoms such as

R05.0 – cough

R06.02 – shortness of breath

Asymptomatic individuals who test positive for COVID -19

Asymptomatic individuals who test positive for COVID -19assign code U07.1.

What is the ICD -10 code for COVID -19 in pregnancy ?

During pregnancy, childbirth and puerperium a patient admitted (or presenting for a health care encounter) because of COVID -19 should receive a principal diagnosis code of O98.5- followed by code U07.1.

What is the Personal history of COVID -19 in ICD-10?

For patient with a history of COVID -19 assign code Z86.16 personal history of COVID -19.

What is the ICD for Post COVID-19 condition ?

For sequela of COVID -19 or associated symptoms or condition that develop following a previous COVID -19 infection, if known and code U09.9 post COVID -19 condition unspecified.

Code U09.9 should not be assigned for manifestation of an active current COVID -19 infection.

The ENd

(HIV AIDS RELATED GUIDELINES 2024 , AIDS guidelines icd 10 cm data 2024, Chapter Wise Guidelines ICD 10 , Sepsis and septic sock guidelines , AIDS guidelines 2024 icd 10 cm , ICD Guidelines )

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HIV AIDS Related Guidelines in ICD 10

(A00-B99)