ICD – 10 Guidelines Chaper-1 Selection and sequencing of HIV code
ICD – 10 Guidelines Chaper-1 Selection and sequencing of HIV code:
2) Selection and sequencing of HIV code
c) Whether the patient is newly diagnosed:
Whether the patient is newly diagnosed or has had previous admissions/encounters for HIV conditions is irrelevant to the sequencing decision.
d) Asymptomatic human immunodeficiency virus:
-> Z21 Asymptomatic human immunodeficiency virus [HIV] infection status, is to be applied when the patient without any documentation of symptoms is listed as being “HIV positive”. “known HIV”, “HIV test positive”, or similar terminology.
-> Do not use this code if the term “AIDS” is used or if the patient is treated for any HIV-related illness or is described as having any condition(s) resulting from his/her HIV positive status; use B20 in these cases.
Scenario:
Patient is coming to hospital with stomach pain who is HIV positive.
How to code?
Principle diagnosis: Stomach pain
Additional diagnosis: Z21
e) Patients with inconclusive HIV serology:
Patients with inconclusive HIV serology, but no definitive diagnosis or manifestations of the illness,may be assigned code R75, Inconclusive laboratory evidence of HIV.
Scenario:
Patient is pregnant came to hospital for HIV test and the result is inconclusive.
How to code?
R75
f) Previously diagnosed HIV – related illness:
Patients with any known prior diagnosis of an HIV-related illness should be coded to B20. Once a patient has developed an HIV – related illness, the patient should always be assigned code on every subsequent admission/encounter. Patients previously diagnosed with any HIV illness (B20) should never be assigned to R75 or Z21, Asymptomatic human immunodeficiency virus [HIV] infection status.
Scenario:
Patient coming with Tuberculosis and previously he diagnosed with HIV.
How to code?
Pdx: B20 Pdx- principle diagnosis
Sdx: TB Sdx- secondary diagnosis.
g) HIV Infection in Pregnancy, Childbirth and the Puerperium:
During pregnancy, childbirth or the puerperium, a patient admitted because of an HIV – related illness should receive a principle diagnosis code of O98.7-, Human immunodeficiency [HIV] disease complicating pregnancy, childbirth and the puerperium, followed by B20 and the code(s) for the HIV – related illness(es). Codes from Chapter 15 always take sequencing priority.
Patients with asymptomatic HIV infection status admitted ( or presenting for health care encounter ) during pregnancy, childbirth, or the puerperium should receive codes of pdx O98.7- and Z21.
Scenario:
Patient is pregnant coming with Cytomegalovirus and she is having HIV disease.
How to code?
Pdx: O98.7
Sdx: B20
Sdx: Cytomegalovirus
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