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ICD-10 Guide
ICD-10 CodesA60.00

A60.00

Herpesviral infection of urogenital system, unspecified

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/05/2025

Code Description

ICD-10 A60.00 is a billable code used to indicate a diagnosis of herpesviral infection of urogenital system, unspecified.

Key Diagnostic Point:

Herpesviral infections of the urogenital system are primarily caused by the herpes simplex virus (HSV), which can lead to a range of clinical manifestations including genital ulcers, dysuria, and systemic symptoms such as fever and malaise. The infection can be asymptomatic or present with recurrent episodes of painful lesions in the genital area. The unspecified nature of this code indicates that the specific type of herpesvirus (HSV-1 or HSV-2) is not documented, which can complicate treatment and management. Diagnosis is typically made through clinical evaluation and may be confirmed with laboratory tests such as PCR or serology. The urogenital system includes the external genitalia, vagina, cervix, urethra, and bladder, and infections can lead to significant morbidity, including psychological distress and complications in pregnancy. Screening for herpesviral infections is recommended for sexually active individuals, particularly those with multiple partners or a history of STIs. Education on safe sex practices and the importance of regular screenings is crucial in managing and preventing the spread of herpesviral infections.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Unspecified nature of the code can lead to ambiguity in documentation.
  • Differentiating between HSV-1 and HSV-2 may require additional clinical information.
  • Potential for co-infection with other STIs complicates coding.
  • Variability in clinical presentation can affect coding accuracy.

Audit Risk Factors

  • Inadequate documentation of symptoms and clinical findings.
  • Failure to specify the type of herpesvirus involved.
  • Lack of supporting laboratory test results.
  • Inconsistent coding practices among different providers.

Specialty Focus

Medical Specialties

Urology

Documentation Requirements

Detailed patient history, including sexual history and symptomatology.

Common Clinical Scenarios

Patients presenting with dysuria, genital lesions, or recurrent infections.

Billing Considerations

Ensure documentation reflects the site of infection and any co-existing conditions.

Gynecology

Documentation Requirements

Comprehensive pelvic examination findings and patient history.

Common Clinical Scenarios

Women presenting with vulvar lesions, pelvic pain, or abnormal discharge.

Billing Considerations

Document any pregnancy-related implications and counseling provided.

Coding Guidelines

Inclusion Criteria

Use A60.00 When
  • According to ICD
  • 10 guidelines, A60
  • 00 should be used when the specific type of herpesvirus is not documented
  • Coders should ensure that the diagnosis is supported by clinical findings and that the documentation aligns with the coding guidelines for urogenital infections

Exclusion Criteria

Do NOT use A60.00 When
No specific exclusions found.

Related CPT Codes

87529CPT Code

Herpes simplex virus (HSV) testing

Clinical Scenario

When a patient presents with symptoms suggestive of herpes.

Documentation Requirements

Document the reason for testing and any relevant clinical findings.

Specialty Considerations

Urologists and gynecologists should ensure that testing aligns with clinical presentations.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of herpes infections, improving the ability to track and manage these conditions. A60.00 serves as a catch-all for unspecified cases, but coders should strive for specificity when possible.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of herpes infections, improving the ability to track and manage these conditions. A60.00 serves as a catch-all for unspecified cases, but coders should strive for specificity when possible.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of herpes infections, improving the ability to track and manage these conditions. A60.00 serves as a catch-all for unspecified cases, but coders should strive for specificity when possible.

Resources

Clinical References

  • •
    CDC Guidelines for STD Prevention

Coding & Billing References

  • •
    CDC Guidelines for STD Prevention

Frequently Asked Questions

What should I document to support the use of A60.00?

Document the patient's symptoms, clinical findings, and any relevant history of STIs. If laboratory tests are performed, include those results in the documentation.