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.
Check B20 with the rest of the claim: free scrubberExcludes1: 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
Their own Excludes1 notes name this code, so the conflict is not listed above.
- D61.81Pancytopenia
- I88Nonspecific lymphadenitis
- Z21Asymptomatic human immunodeficiency virus [HIV] infection status
- L04Acute lymphadenitis
- R62.5Other and unspecified lack of expected normal physiological development in childhood
- R75Inconclusive laboratory evidence of human immunodeficiency virus [HIV]
- D89.89Other specified disorders involving the immune mechanism, not elsewhere classified
- B97.3Retrovirus as the cause of diseases classified elsewhere
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. Look up the whole chart to see which of its HCCs the hierarchy would zero.
Medicare coverage
B20 is named in 45 Medicare coverage policies: 45 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A52466Nebulizers - Policy Article
- A52996Billing and Coding: Routine Foot Care
- A53060Billing and Coding: Ophthalmology: Extended Ophthalmoscopy and Fundus Photography
- A55717Billing and Coding: Lab: Flow Cytometry
Alphabetic index entries that lead here
- 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)
Code history
Unchanged in every release from FY2024 to FY2027.