ICD-10 Coding for Herpes Simplex Infection(B00.1, B00.2)
Complete ICD-10-CM coding and documentation guide for Herpes Simplex Infection. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Herpes Simplex Infection
B00Primary Range
Herpesviral [herpes simplex] infections
This range includes all herpes simplex infections, categorized by site and manifestation.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| B00.1 | Herpesviral vesicular dermatitis | Use for confirmed herpes simplex vesicular dermatitis with lab confirmation. |
|
| B00.2 | Herpesviral gingivostomatitis and pharyngotonsillitis | Use for confirmed herpes simplex infections of the oral cavity. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for herpes simplex infection
Essential facts and insights about Herpes Simplex Infection
Primary ICD-10-CM Codes for herpes simplex infection
Decision Criteria
clinical Criteria
- Presence of vesicular lesions confirmed by PCR
Applicable To
- Herpetic eczema
- Herpes simplex dermatitis
Excludes
- Herpes zoster (B02.-)
Clinical Validation Requirements
- PCR positive for HSV
- Presence of vesicular lesions
Code-Specific Risks
- Misclassification as unspecified dermatitis
Coding Notes
- Ensure documentation specifies lesion location and HSV type.
B00.2 - Herpesviral gingivostomatitis and pharyngotonsillitis
Use for confirmed herpes simplex infections of the oral cavity.
Applicable To
- Herpetic pharyngitis
- Herpes simplex gingivostomatitis
Excludes
- Herpes zoster (B02.-)
Clinical Validation Requirements
- PCR positive for HSV
- Presence of oral ulcers
Coding Notes
Document specific oral sites affected and confirm with lab tests.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Encounter for screening for infections with a predominantly sexual mode of transmission
Z11.3Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Herpes Simplex Infection to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code B00.1.
Impact
Clinical: May lead to inappropriate treatment., Regulatory: Non-compliance with documentation standards., Financial: Potential for denied claims.
Mitigation Strategy
Always confirm HSV type with lab tests, Include type in clinical documentation
Impact
Reimbursement: May lead to reduced reimbursement rates., Compliance: Non-compliance with ICD-10 coding guidelines., Data Quality: Decreases accuracy of clinical data.
Mitigation Strategy
Always use the most specific code available, such as B00.1 for vesicular dermatitis.
Impact
High risk of audit if unspecified codes are used when specific codes are available.
Mitigation Strategy
Ensure documentation supports the use of specific codes.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Herpes Simplex Infection, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Herpes Simplex Infection
Use these documentation templates to ensure complete and accurate documentation for Herpes Simplex Infection. These templates include all required elements for proper coding and billing.
HSV Encephalitis in Emergency Department
Specialty: NeurologyRequired Elements
- Patient history
- CSF analysis
- PCR results
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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