B95-B97 — Bacterial and viral infectious agents
ICD-10-CM codes B95-B97 cover bacterial and viral infectious agents, within certain infectious and parasitic diseases. The block holds 56 codes across 3 categories, of which 46 are billable and 10 are header codes that cannot be submitted on a claim.
Notes
Additional guidance from the ICD-10-CM tabular list.
- These categories are provided for use as supplementary or additional codes to identify the infectious agent(s) in diseases classified elsewhere.
Risk adjustment in B95-B97
0 codes in this block map to a CMS-HCC, which means the diagnosis carries a risk-adjustment payment when it is documented and coded. Under-coding here is money left on the table; over-coding here is what audits are for.
- HCC 1 HIV/AIDS
What else to watch in B95-B97
- 27 codes are named in Medicare coverage policies. An LCD or NCD lists them as supporting medical necessity, or explicitly as not supporting it. Which applies depends on the MAC for your state.