B20 — Human immunodeficiency virus [HIV] disease
B20 is a billable, specific ICD-10-CM code for human immunodeficiency virus [hiv] disease. It is valid for submission on a claim.
Excludes1 — never code together
These conditions cannot occur together. Billing both on the same encounter is a denial.
Code first
The underlying condition must be sequenced before this code.
- Human immunodeficiency virus [HIV] disease complicating pregnancy, childbirth and the puerperium, if applicable (O98.7-)
Use additional code
Add a secondary code to capture the detail described below.
- code(s) to identify all manifestations of HIV infection
Includes
Conditions this code covers.
- acquired immune deficiency syndrome [AIDS]
- AIDS-related complex [ARC]
- HIV infection, symptomatic
Other codes that can never be billed with B20
These codes carry an Excludes1 note pointing at B20. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading B20 alone.
- L04Acute lymphadenitis
- R62.5Other and unspecified lack of expected normal physiological development in childhood
- R75Inconclusive laboratory evidence of human immunodeficiency virus [HIV]
- B97.3Retrovirus as the cause of diseases classified elsewhere
- D84.81Immunodeficiency due to conditions classified elsewhere
- D89.89Other specified disorders involving the immune mechanism, not elsewhere classified
- D61.81Pancytopenia
- I88Nonspecific lymphadenitis
Risk adjustment
B20 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 1 HIV/AIDS0.301 RAF
Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score.
Medicare coverage
B20 is named in 75 Medicare coverage policies — 75 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A52466Nebulizers - Policy Article
- A52466Nebulizers - Policy Article
- A52466Nebulizers - Policy Article
- A52466Nebulizers - Policy Article
How B20 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to B20.
- AIDS(related complex)
- ARC(AIDS-related complex)
- HIV
- Slim disease(in HIV infection)
- Acquired›immunodeficiency syndrome(AIDS)
- Disease, diseased›human immunodeficiency virus(HIV)
- Disease, diseased›slim(HIV)
- Human›immunodeficiency virus(HIV) disease (infection)
- Syndrome›HIV infection, acute
- Dementia›in›human immunodeficiency virus disease(HIV)
- Disease, diseased›viral, virus›human immunodeficiency(HIV)
- Encephalitis›due to›human immunodeficiency virus disease(HIV)
Questions about B20
- Is B20 a billable ICD-10-CM code?
- Yes. B20 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does B20 sit in the tabular list?
- Certain infectious and parasitic diseases (A00-B99), in the block Human immunodeficiency virus [HIV] disease (B20).
- What cannot be coded together with B20?
- B20 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.