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v1.0.0
ICD-10 Guide
ICD-10 CodesA92

A92

West Nile virus infection

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

Code Description

ICD-10 A92 is a billable code used to indicate a diagnosis of west nile virus infection.

Key Diagnostic Point:

West Nile virus infection is an arthropod-borne viral disease primarily transmitted to humans through the bite of infected mosquitoes. The virus, which belongs to the flavivirus genus, can lead to a range of clinical manifestations, from asymptomatic infection to severe neurological disease. Symptoms typically appear 3 to 14 days after exposure and may include fever, headache, body aches, joint pain, vomiting, diarrhea, and rash. In severe cases, the infection can progress to neuroinvasive diseases such as meningitis or encephalitis, which can result in long-term neurological complications or death. Risk factors for severe disease include age, immunocompromised status, and certain underlying health conditions. Travel history is crucial in diagnosing West Nile virus, especially for patients returning from endemic areas. Laboratory confirmation is often achieved through serological testing for IgM antibodies or PCR testing of cerebrospinal fluid in cases of neurological involvement. Public health measures focus on mosquito control and personal protective measures to reduce transmission.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Need for accurate travel history documentation
  • Differentiation from other arboviral infections
  • Potential for severe complications requiring detailed coding
  • Variability in clinical presentation

Audit Risk Factors

  • Inadequate documentation of travel history
  • Failure to document neurological symptoms
  • Misclassification of the severity of the infection
  • Lack of laboratory confirmation in medical records

Specialty Focus

Medical Specialties

Infectious Disease

Documentation Requirements

Detailed travel history, symptom onset, and laboratory results.

Common Clinical Scenarios

Patients presenting with fever and neurological symptoms after travel to endemic areas.

Billing Considerations

Ensure all relevant tests and symptoms are documented to support the diagnosis.

Neurology

Documentation Requirements

Neurological examination findings, imaging results, and treatment plans.

Common Clinical Scenarios

Patients with encephalitis or meningitis symptoms linked to West Nile virus.

Billing Considerations

Documenting the severity of neurological involvement is critical for accurate coding.

Coding Guidelines

Inclusion Criteria

Use A92 When
  • According to the official coding guidelines, A92 should be used for confirmed cases of West Nile virus infection
  • Documentation must support the diagnosis, including travel history and clinical findings

Exclusion Criteria

Do NOT use A92 When
  • Exclude cases where the infection is not confirmed or where symptoms are attributed to other conditions

Related Codes

Child Codes

12 codes
A92.0
Chikungunya virus disease
A92.1
Chikungunya virus disease
A92.2
West Nile virus infection.
A92.3
Chikungunya virus disease
A92.30
West Nile virus infection, unspecified
A92.31
West Nile virus infection with encephalitis
A92.32
West Nile virus infection with other neurologic manifestation
A92.39
West Nile virus infection with other complications
A92.4
Chikungunya virus disease
A92.5
West Nile virus infection.
A92.8
Other specified mosquito-borne viral fevers
A92.9
West Nile virus infection, unspecified

Related CPT Codes

86790CPT Code

West Nile virus antibody test

Clinical Scenario

Used to confirm diagnosis in suspected cases.

Documentation Requirements

Document the reason for testing and results.

Specialty Considerations

Infectious disease specialists should ensure comprehensive testing is documented.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of West Nile virus infection, improving data accuracy and enabling better tracking of disease incidence and outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of West Nile virus infection, improving data accuracy and enabling better tracking of disease incidence and outcomes.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of West Nile virus infection, improving data accuracy and enabling better tracking of disease incidence and outcomes.

Resources

Clinical References

  • •
    CDC West Nile Virus Information

Coding & Billing References

  • •
    CDC West Nile Virus Information

Frequently Asked Questions

What are the common symptoms of West Nile virus infection?

Common symptoms include fever, headache, body aches, joint pain, vomiting, diarrhea, and rash. Severe cases may present with neurological symptoms such as confusion, seizures, or paralysis.

How is West Nile virus diagnosed?

Diagnosis is typically made through clinical evaluation, travel history, and laboratory testing for antibodies or viral RNA.