Coding HIV Infections Flashcards
HIV Sequencing
Depends on the reason for admission/encounter. When a patient is admitted for an HIV-related condition, 042 is sequenced first, followed by additional diagnosis codes for all reported HIV-related conditions. Conditions always considered HIV related include Kaposi’s sarcoma, lymphoma, Pneumocystis carinii pneumonia (PCP), cryptococcal meningitis, and cytomegaloviral disease.
If a patient w/ HIV is admitted for an unrelated condition (eg, fracture), the code for the unrelated condition is sequenced first. Code 042 is reported as an additional diagnosis, as are any HIV related conditions.
V08 Asymptomatic human immunodeficiency virus [HIV] infection status
This code is applied when the patient is HIV positive and does not have any documented symptoms of HIV-related illness. Do not use this code if the term AIDS is used. If the patient is treated for any HIV-related illness, or is described as having any condition resulting from HIV positive status, use 042.
795.75 Nonsepecific serologic evidence of human immunodeficiency virus [HIV]
This code can be used for patients with inconclusive HIV serology, and no definitive diagnosis or manifestations of the illness.
Prior diagnosis of HIV
should be coded to 042. After a patient has developed an HIV-related illness, the patient’s condition should be assigned code 042 on every subsequent admission/encounter. Never assign 795.71 or V08 to a patients with an earlier diagnosis of AIDS or symptomatic HIV (042)
647.6x Other viral diseases in the mother, classifiable elsewhere, but complicating the pregnancy, childbirth or the puerperium
Use this code when HIV infection status is during pregnancy. Use V08 only if the patient is asymptomatic with no history of an HIV-related illness. When the encounter is to treat an HIV-related illness, or a patient who has had an HIV-related illness in the past, the proper sequence is 647.6x, 042, and the code for the HIV-related illness if treated during the current encounter. Codes from ICD-9-CM Chapter 11 (Compliacations of Pregnancy) always take sequencing priority and should be listed first.
A patient who is four weeks pregnant is diagnosed with HIV. She has not experienced any HIV-related conditions. What is the proper coding sequence?
647.63, V08: 647.63 (Other viral diseases in the mother, classifiable elsewhere, but complicating the pregnancy, childbirth or the puerperium) because the patient neither has any symptoms of HIV nor is there documentation of any past HIV-related illnesses. Then code V08 (Asymptomatic human immunodeficiency virus [HIV] infection status) is reported second.
Codes from ICD-9-CM Chapter 11 (Compliacations of Pregnancy) always take sequencing priority and should be listed first.
What codes should you use if a patient is being seen to determine HIV status?
V73.89 Screening for other specified viral diseases. Use code V69.8 Other problems related to lifestyle as a secondary code if an asymptomatic patient is in a known high-risk group for HIV.
What codes should you use if a patient with signs, symptoms or illness, or a confirmed HIV related diagnosis be tested for HIV?
Code the signs, and symptoms or the diagnosis. If the results are positive and the patient is symptomatic, report code 042 with codes for the HIV related symptoms or diagnosis. The HIV counseling code (V65.44) may be used if couseling is provided for patients with positive test results.
HIV 1): Code only confirmed cases
Code only firmed cases of HIV infection/illness. This is an exception to the hospital inpatient guideline Section II, H.
In this context, “confirmation” does not require documentation of positive serology or culture for HIV; the provider’s diagnostic statement that the patient is HIV positive, or has an HIV-related illness is sufficient.
HIV 2a: Patient admitted for HIV-related condition
If a patient is admitted for an HIV-related condition, the principal diagnosis should be 042, followed by additional diagnosis codes for all reported HIV-related conditions.
HIV 2b: Patient with HIV diesase admitted for unrelated condition.
If a patient with HIV disease is admitted for an unrelated condition (such as traumatic injury), the code for the unrelated condition (eg, the nature of injury code) should be the principal diagnosis. Other diagnoses would be 042 followed by additonal diagnosis codes for all reported HIV-related conditions.
HIV 2c: Whether the patient is newly diagnosed
Whether the patient is newly diagnosed or has had previous admissions/encounters for HIV conditions is irrelevant to the sequencing decision.
HIV 2d: Asymtomatic HIV
V08 V08 Asymptomatic human immunodeficiency virus [HIV] infection status, is applied when the patient without any documentation of symptoms is listed as being “HIV positive,” “knownHIV,” “HIV test positive,” or similar terminology. Do not use this code if the term “AIDS” is used or if the patient is treated for any HIV-related illness or is described as having any condition(s) resulting from his/her HIV positive status; use 042 in these cases.
HIV 2e: Patients with inconclusive HIV serology
Patients with inconclusive HIV serology, but no definitive diagnosis or manifestations of the illness, may be assigned code 735.71, Inconclusive serologic test for HIV.
HIV 2f: Previously diagnosed HIV-related illness
Patients with any known prior diagnosis of any HIV-related illness should be coded to 042. Once a patient has developed an HIV-related illness, the patient should always be assigned code 042 on every subsequent admission/encounter. Patients previously diagnosed with any HIV illness (042) should never be assigned to 795.71 or V08.
