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Home/Diagnosis/ICD-10 Coding for Respiratory Syncytial Virus

ICD-10 Coding for Respiratory Syncytial Virus

J12.1
J21.0
B97.4

Complete ICD-10-CM coding and documentation guide for icd-10 coding for respiratory syncytial virus includes clinical validation requirements, medical necessity guidelines, and coding policies.

Also Known as:
RSV
RSV Infection
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Key Information: ICD-10 Coding for Respiratory Syncytial Virus

Essential facts and insights about ICD-10 Coding for Respiratory Syncytial Virus

Use ICD-10 code J12.1 for rsv pneumonia, ensuring proper documentation in clinical notes.

Primary ICD-10-CM Codes

RSV pneumonia

Billable Code
J12.1
Billable

Diagnostic Criteria

  • • RSV+ PCR or antigen test
  • • Chest X-ray showing infiltrates

Applicable To

  • • Pneumonia due to RSV

Important Notes

  • • Ensure RSV is documented as the primary cause of pneumonia.

RSV bronchiolitis

Billable Code
J21.0
Billable

Diagnostic Criteria

  • • RSV+ PCR or antigen test
  • • Clinical symptoms of bronchiolitis in infants

Applicable To

  • • Acute bronchiolitis due to RSV

Important Notes

  • • Document age and specific symptoms to support bronchiolitis coding.

RSV as the cause of diseases classified elsewhere

Billable Code
B97.4
Billable

Diagnostic Criteria

  • • RSV+ test
  • • Provider documentation linking RSV to another condition

Applicable To

  • • RSV as a secondary cause

Important Notes

  • • Ensure clear documentation of RSV as a secondary cause.
Ancillary Codes

Additional codes that may be used with this diagnosis

B97.4

RSV as the cause of diseases classified elsewhere

Use as a secondary code when RSV causes a condition not primarily classified under RSV.

Frequently Asked Questions

What is the ICD-10 code for RSV pneumonia?

The ICD-10 code for RSV pneumonia is J12.1, used when RSV is confirmed as the cause of pneumonia.

How do you code RSV bronchiolitis?

RSV bronchiolitis is coded as J21.0, applicable for infants with confirmed RSV infection and bronchiolitis symptoms.

When should B97.4 be used in RSV coding?

B97.4 is used as a secondary code when RSV causes a condition classified elsewhere, requiring a primary condition code.

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