A92.5 — Zika virus disease
A92.5 is a billable, specific ICD-10-CM code for zika virus 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.
- congenital Zika virus disease (P35.4)
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Zika virus fever
- Zika virus infection
- Zika NOS
Risk adjustment
A92.5 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Medicare coverage
A92.5 is named in 2 Medicare coverage policies — 2 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A55326Billing and Coding: Zika Virus Testing by PCR and ELISA Methods
- A56771Billing and Coding: Special Electroencephalography
How A92.5 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 A92.5.
- Zika NOS
- Disease, diseased›Zika virus
- Fever›Zika virus
- Infection, infected, infective›Zika virus
Related codes at this level
Codes that share A92. If A92.5 is not quite right, the correct code is usually one of these.
Questions about A92.5
- Is A92.5 a billable ICD-10-CM code?
- Yes. A92.5 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does A92.5 sit in the tabular list?
- Certain infectious and parasitic diseases (A00-B99), in the block Arthropod-borne viral fevers and viral hemorrhagic fevers (A90-A99).
- What cannot be coded together with A92.5?
- A92.5 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.