2025 ICD-10-CM code B97
(Active) Effective Date: N/A Infectious and parasitic diseases - Bacterial and viral infectious agents Certain infectious and parasitic diseases Feed
Viral agents as the cause of diseases classified elsewhere.
Medical necessity is determined by the primary disease or condition caused by the viral agent. The B97 code adds specificity to the diagnosis but doesn't have its own medical necessity requirements.
Clinicians should use this code in conjunction with other codes identifying the specific disease(s) or condition(s) caused by the viral agent.It's important to identify the virus through appropriate testing if possible.
In simple words: This code identifies a virus as the cause of a disease, but it's not the main code used for the disease itself.It's like adding a note saying "caused by a virus."The main code for the disease should be listed first.
This code is used as a supplementary or additional code to identify the viral agent in diseases classified elsewhere. It should not be used as the primary diagnosis.
Example 1: A patient is diagnosed with pneumonia (J18.9) and laboratory testing confirms the presence of a respiratory syncytial virus (RSV).The physician would report J18.9 as the primary diagnosis, followed by B97 to specify the viral etiology., A patient presents with gastroenteritis and testing reveals norovirus. The physician would list a code from the appropriate category for gastroenteritis (e.g., A08.4) followed by B97 to indicate the viral cause., A patient has infectious conjunctivitis, and adenovirus is identified. Code H10.0 (or a more specific code if available for infectious conjunctivitis) is listed first, followed by B97 to indicate the viral agent.
Documentation should include the specific disease or condition, as well as the laboratory confirmation of the viral agent if available. Symptoms, physical examination findings, and diagnostic test results are essential.
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- Specialties:Infectious Disease, Internal Medicine, Family Medicine, Pediatrics, and other specialties depending on the manifestation of the viral infection.
- Place of Service:Inpatient Hospital, On Campus-Outpatient Hospital, Off Campus-Outpatient Hospital, Office, Emergency Room - Hospital, and other places of service depending on the severity and clinical presentation of the disease.