The January 2015 issue of the CCHIS Newsletter "Coding Yesterday's Nomenclature Today" discusses Human Immunodeficiency Virus (HIV) Infection coding guidelines in both ICD-9 CM and ICD-10 CM.

1. FACTS:
 This particular virus can only infect human beings.
 It weakens the immune system by destroying important cells that
fight disease and infection.
 The virus can only reproduce itself by taking over a cell in the body
of its host.
 Not everyone who has HIV progresses to Acquired
Immunodeficiency Syndrome (AIDS).
 AIDS is the final stage of HIV infection.
 The patient is considered to have progressed to AIDS if you have
one or more specific opportunistic infections, certain cancers, or a
very low number of CD4 cells.
H-Human
I-Immunodeficiency
V-Virus
HUMAN IMMUNODEFICIENCY VIRUS (HIV) INFECTION
WHAT TO EXPECT
1 Human Immunodeficiency
Virus (HIV) Infection
2 Opportunistic Infections and
Cancers
3 Comparison/Contrast
4 Requests for Coding Topics
January 2015
Volume 2 Issue 1
By Cynthia Brown, MBA, RHIT, CCS
www.cyntcodinghealthinformationservices.com
CCHIS, P.O. Box 3019, Decatur, GA 30031 404-992-8984
http://www.cyntcodinghealthinformationservices.com
Cynthia@cyntcodinghealthinformationservices.com [phone]
CODING YESTERDAY’S NOMENCLATURE TODAY®
HUMAN IMMUNODEFICIENCY VIRUS (HIV)
INFECTION, ICD-9 CM & ICD-10 CM CODING
CODING NEWSLETTER FOR HEALTHCARE
CODING PROFESSIONALS

2. Page 2 Coding Yesterday’s Nomenclature Today
Opportunistic Infections
Candidiasis of Bronchi, Trachea,
Esophagus, or Lungs
Coccidioidomycosis
Cryptococcosis
Cryptosporidiosis, Chronic Intestinal
(greater than 1 month’s duration
Cytomegalovirus Disease
Encephalopathy (HIV related)
Herpes Simplex
Chronic Ulcers (greater than 1 month)
Bronchitis, Pneumonitis, or
Esophagitis
Histoplasmosis
Isosporiasis, Chronic Intestinal
(greater than 1 month’s duration)
Mycobacterium Avium Complex
Tuberculosis
Pneumocystis Carinii Pneumonia
Pneumonia, Recurrent
Progressive Multifocal
Leukoencephalopathy
Salmonella Septicemia, Recurrent
Toxoplasmosis of Brain
Wasting Syndrome due to HIV
CANCERS
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Invasive
Cervical
Cancer
Kaposi’s
Sarcoma
Anal Cancer
Lymphoma,
Multiple
Forms“Certain Cancers are Indicative of
AIDS”
A patient with one or
more opportunistic
infections is
considered to have
AIDS
Opportunistic Infections and Cancers

3. Coding Yesterday’s Nomenclature Today
ICD-9 CM & ICD-10 CM COMPARISON/CONTRAST
ICD-9 CM ICD-10 CM
Code only confirm cases of HIV
(provider documentation or HIV-
related illness is considered
positive).
Code only confirm cases of HIV
(provider documentation or HIV-
related illness is considered
positive).
Sequence 042 1st
& HIV-related
illnesses second when admitted for
HIV-related condition.
Sequence B20 1st
& HIV-related
illnesses second when admitted for
HIV-related condition.
Unrelated condition(s) sequenced
1st
followed by HIV-related
conditions when admitted for
unrelated condition(s).
Unrelated condition(s) sequenced
1st
followed by HIV-related
conditions when admitted for
unrelated condition(s).
V08 for asymptomatic HIV status
is used when patient does not have
documented symptoms but is
considered HIV positive.
Z21 for asymptomatic HIV status is
used when patient does not have
documented symptoms but is
considered HIV positive.
Inconclusive HIV serology without
a definitive diagnosis or
manifestations is coded to 795.71.
Inconclusive HIV serology without
a definitive diagnosis or
manifestations is coded to R75.
Prior diagnoses of HIV-related
illnesses are coded to 042.
Prior diagnoses of HIV-related
illnesses are coded to B20.
During Pregnancy, Childbirth, or
the Puerperium, HIV patients are
assigned 1st
647.6X followed by
042 and then the HIV-related
illness. Asymptomatic patients are
assigned 647.6X followed by V08.
During Pregnancy, Childbirth, or
the Puerperium, HIV patients are
assigned 1st
O98.7- followed by
B20 and then the HIV-related
illness. Asymptomatic patients are
assigned O98.7- followed by Z21.
If patient is testing to determine
HIV status use code V73.89
followed by codes for any high risk
behavior codes. If the patient has
signs and symptoms, code the signs
and symptoms along with V65.44 if
counseling is provided. When
patient returns for results use
V65.44 if negative or follow
previous guidelines if positive.
If patient is testing to determine
HIV status use code Z11.4
followed by codes for any high risk
behavior codes. If the patient has
signs and symptoms, code the signs
and symptoms along with Z71.7 if
counseling is provided. When
patient returns for results use Z71.7
if negative or follow previous
guidelines if positive.
NOTE: Whether the patient is newly diagnosed in BOTH
nomenclatures or has had previous admissions/encounters for HIV
conditions is irrelevant to the sequencing decision. Follow the above-
mentioned guidelines for proper sequencing.
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Trainer
ALL THINGS CODING®
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complete coding is a
must in today’s
economically
challenged healthcare
environment.”

4. Page 4 Coding Yesterday’s Nomenclature Today
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