Wiki HIV vs AIDS dx

[debi7478]

Trying to pick up HCC codes for HIV pts B20 vs Z21 How are coders educating physicians to document to determine which code should be used. I have been told the CDC stages of Disease with CD4 counts is how the MD is coding. I rarely see any documentation on any HIV related illnesses but the code being used VERY frequently is B20.... Any education hints would be great! I have read the ICD-10 guidelines but the documentation is my issue and how to help the providers with it....

Thanks in advance for the assist.... January sweeps are coming up soon! need clarification on this

 

[CodingKing]

Looks at ICD-10 coding guidelines I.C.1.a.2.f for more information.

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
diagnosed with any HIV illness (B20) should never be
assigned to R75 or Z21, Asymptomatic human
immunodeficiency virus [HIV] infection status.

This applies even if their AIDS related illness clears up. Once you are B20 you are always B20.

This has not changed from ICD-9. V08 was used until AIDS related illness occurrs where they would then be 042. Once they are 042 they dont go back to V08, even if they are asymptomatic.

 

[Daniel Rowden]

Yes, as it stands once a patient is diagnosed with an AIDs defining illness or an AIDs defining CD4 count the physician can (and should) continue to say AIDs and B20 should be coded even if the patient is completely back to be undetectable and has no current AIDs illness. The management of the patient forever changes once this has occurred (they are far more aggressive with follow up etc)

However, having said that the physician must state either AIDs or HIV with history of related illness (or something like this) and we are absolutely allowed to code it as B20. You cannot see HIV and an AIDs related illness and assume if the doctor does not link it. You would need to query the doctor.

 

[sstgermain]

Looks at ICD-10 coding guidelines I.C.1.a.2.f for more information.



This applies even if their AIDS related illness clears up. Once you are B20 you are always B20.

This has not changed from ICD-9. V08 was used until AIDS related illness occurrs where they would then be 042. Once they are 042 they dont go back to V08, even if they are asymptomatic.

So in an OSHPD report if they WERE at one point B20 and now they come to a different facility and all we know is that they are HIV positive, would it come back as a ERROR if we have them at Z21?