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December 1 is being observed as World AIDS Day since 1988. Sponsored by the United Nations Programme on HIV and AIDS (UNAIDS), this one-day campaign provides opportunity to support those living with HIV and improve understanding of this global public health concern. Caused by the human immunodeficiency virus (HIV), acquired immunodeficiency syndrome (AIDS) is a chronic, potentially life-threatening condition. According to the CDC reports, an estimated 1,189,700 people in the United States had HIV at the end of 2019. WHO report highlights that 1,500,000 people were newly infected in 2020.

“End inequalities. End AIDS. End pandemics.” is the theme of World AIDS Day 2021. This theme provides special focus on reaching people left behind and highlights the growing inequalities in access to essential HIV services. HIV attacks the body’s white blood cells and the infection can lead to illnesses, cancers, or neurological problems.

Healthcare providers treating HIV patients need to document all healthcare details of their patients, both from the point of view of efficient ongoing care and from that of medical reimbursement. Nurse practitioners (NP), HIV specialists, OB-GYN providers and infectious disease specialists involved in treating AIDS can take support from medical billing and coding companies for timely claim submissions for accurate reimbursement. Healthcare practices can create campaigns to increase awareness on the importance of HIV testing and improve education to prevent HIV.

With AIDS awareness being promoted this day, it is also a great time for coding and billing professionals to review the medical codes for AIDS/ HIV.

ICD-10 Codes

  • B20 Human immunodeficiency virus [HIV] disease
  • B97.35 Human immunodeficiency virus, type 2 [HIV 2] as the cause of diseases classified elsewhere
  • R75 Inconclusive laboratory evidence of human immunodeficiency virus [HIV]
  • Z20.6 Contact with and (suspected) exposure to human immunodeficiency virus [HIV]
  • Z21 Asymptomatic human immunodeficiency virus [HIV] infection status
  • Z11.4 Encounter for screening for human immunodeficiency virus [HIV]
  • Z71.7 Human immunodeficiency virus [HIV] counseling
  • Z83.0 Family history of human immunodeficiency virus [HIV] disease

HIV complications

  • O98.7 Human immunodeficiency virus [HIV] disease complicating pregnancy, childbirth and the puerperium
  • O98.71 Human immunodeficiency virus [HIV] disease complicating pregnancy
  • O98.72 Human immunodeficiency virus [HIV] disease complicating childbirth
  • O98.73 Human immunodeficiency virus [HIV] disease complicating the puerperium

Coding Tips

  • Use the ICD-10-CM code Z21 only when there is no documentation of symptoms, or if the patient is described as HIV positive
  • Use code B20, if the provider documents AIDS, or if the patient is treated for any HIV-related illness
  • Code Z21 is never again apply to the patient, who has developed any HIV-related illness
  • Never alternate between the codes, based on whether or not the patient has an HIV-related illness on a given date of service

AIDS is the most difficult stage of HIV infection. It can severely damage the immune system and the common symptoms of the infection include chronic diarrhea, weakness, chills, recurring fever, and weight loss. Getting tested is the only way to detect HIV. Diagnosis tests include nucleic acid tests (NATs) and antigen/antibody tests. Other tests such as CD4 T cell count, Viral load (HIV RNA), and Drug resistance are recommended to determine the stage of the disease. The main treatment is Anti-Retroviral Therapy (ART), which combines three or more medications from several different drug classes to stop the virus replicating in the body and to recover the immune system.

Certain complications that are associated with antiretroviral (ARV) therapy include bone marrow suppression, anorexia, hypertension, high blood sugar and diabetes, heart disease, avascular bone necrosis, nausea, hypersensitivity reactions, hyperlipidemia, atherosclerosis, hypothyroidism, hypogonadism and gout. Such complications can also be reported using specific ICD-10 codes such as –

  • E03.3 Post-infectious hypothyroidism
  • E78.5 Hyperlipidemia, unspecified
  • I63 Cerebral infarction
  • I70 Atherosclerosis
  • M10 Gout
  • R11 Nausea and vomiting
  • R63.0 Anorexia

To report the diagnosis and treatment procedures of HIV/AIDS, medical practices can consider medical coding outsourcing services. Professional medical billing companies will be up to date with all billing and coding guidelines.