B25-B34 — Other viral diseases
ICD-10-CM codes B25-B34 cover other viral diseases, within certain infectious and parasitic diseases. The block holds 67 codes across 6 categories, of which 55 are billable and 12 are header codes that cannot be submitted on a claim.
Risk adjustment in B25-B34
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 6 Opportunistic Infections
- HCC 92 Bone/Joint/Muscle/Severe Soft Tissue Infections/Necrosis
- HCC 227 Cardiomyopathy/Myocarditis
What else to watch in B25-B34
- 25 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.