Lecture on HIV Coding Guidelines

HIV Overview

• HIV: Human Immunodeficiency Virus
  • Virus attacks cells that help the body fight infection
  • No cure but treatable with medication
  • Can become undetectable with proper treatment

Key Coding Guidelines

• B20: HIV/AIDS
  • Once a patient is diagnosed with HIV/AIDS (B20), no other HIV-related codes should be used for that patient
• Related Codes:
  • R75: Inconclusive laboratory evidence of HIV
  • Z20.6: Contact with and suspected exposure to HIV
  • Z11.4: Encounter for screening for HIV
  • Z71.7: HIV counseling (when negative result and no symptoms)
  • Z21: Asymptomatic HIV (no symptoms)
  • O98.7: HIV disease complicating pregnancy, childbirth, and the puerperium

Sequencing Guidelines

• If reason for encounter (RFE) is an HIV/AIDS-related condition: HIV/AIDS is sequenced first
• If RFE is not related to HIV/AIDS: Sequence that condition first, followed by HIV/AIDS

Example Scenarios

• Scenario 1: Patient has HIV/AIDS (B20), Inconclusive lab evidence (R75), Exposure to HIV (Z20.6), Screening (Z11.4), Counseling (Z71.7), and Asymptomatic (Z21)
• Scenario 2: Sequence for HIV-related conditions separately for encounters involving related conditions or symptoms
• Scenario 3: Pregnancy with HIV-related conditions were addressed

Key Points to Remember

• Category Recognitions: Know infectious disease code ranges (A00-B99)
• First Listed Code: Signs and symptoms can only be first listed if no diagnosis is present
• Infectious Disease Codes: Always sequence HIV/AIDS or related conditions following the primary reason for the encounter

Practice Quiz

• Question 1: Patient with HIV/AIDS and inconclusive lab result
  • Answer: B20, R75
• Question 2: Encounter for HIV screening
  • Answer: Z11.4
• Question 3: HIV counseling with negative result
  • Answer: Z71.7
• Question 4: Asymptomatic HIV patient
  • Answer: Z21

Scenario Practice

• Example: Pregnant woman with HIV/AIDS at 16 weeks
  • Codes: O98.7, B20, Z3A.16
• Analyzing Diagnoses: Remove non-primary symptoms, focus on documented diagnoses
• Common Mistakes: Incorrectly sequencing HIV/AIDS codes or misidentifying primary condition

Useful Tips

• Highlight Key Terms: In diagnoses, signs, and symptoms
• Use Guidelines Accordingly: Chapter 15 codes take precedence in pregnancy
• RFE Chart: Signs and symptoms should not be coded if integral to a diagnosis
• Memorize Key Codes: Such as B20 and Z21 for quick reference
• Use Additional Codes: Always remember additional codes for specific conditions

Summary

• Practice identifying and applying correct codes in various scenarios
• Consistent repetition will help solidify the guidelines and proper sequence
• Understanding and referencing guidelines are crucial for accuracy