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v1.0.0
ICD-10 Guide
ICD-10 CodesA92.30

A92.30

West Nile virus infection, unspecified

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

Code Description

ICD-10 A92.30 is a billable code used to indicate a diagnosis of west nile virus infection, unspecified.

Key Diagnostic Point:

West Nile virus infection is an arthropod-borne viral infection primarily transmitted to humans through the bite of infected mosquitoes. The virus can lead to a range of clinical manifestations, from asymptomatic infection to severe neurological disease, including encephalitis and meningitis. Symptoms typically appear 3 to 14 days after exposure and may include fever, headache, body aches, joint pain, vomiting, diarrhea, and rash. Severe cases can result in long-term neurological complications or death. The infection is most prevalent in areas where mosquitoes are abundant, particularly during warmer months. Travel history is crucial in diagnosing West Nile virus, as outbreaks are more common in certain regions, particularly in North America, Europe, and parts of Africa and Asia. Diagnosis is often confirmed through serological testing or PCR, and treatment is primarily supportive, focusing on symptom management. Understanding the epidemiology of the virus, including potential exposure to mosquito habitats, is essential for accurate diagnosis and coding.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Varied clinical presentations ranging from asymptomatic to severe disease.
  • Need for thorough travel history to determine exposure risk.
  • Differentiation from other arboviral infections such as Zika and dengue.
  • Potential for co-infections with other mosquito-borne viruses.

Audit Risk Factors

  • Inadequate documentation of travel history.
  • Failure to specify the severity of the infection.
  • Misclassification of symptoms as unrelated to West Nile virus.
  • Lack of laboratory confirmation in cases of severe symptoms.

Specialty Focus

Medical Specialties

Infectious Disease

Documentation Requirements

Detailed patient history, including travel and exposure history, clinical symptoms, and laboratory results.

Common Clinical Scenarios

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

Billing Considerations

Consideration of differential diagnoses and potential co-infections with other arboviruses.

Emergency Medicine

Documentation Requirements

Thorough documentation of presenting symptoms, travel history, and any immediate interventions.

Common Clinical Scenarios

Patients presenting with acute febrile illness and neurological signs.

Billing Considerations

Rapid assessment and documentation are critical for timely diagnosis and treatment.

Coding Guidelines

Inclusion Criteria

Use A92.30 When
  • According to the official coding guidelines, A92
  • 30 should be used when the specific type of West Nile virus infection is not documented
  • It is important to include relevant clinical information and travel history to support the diagnosis

Exclusion Criteria

Do NOT use A92.30 When
  • Exclusion criteria include other specified arboviral infections

Related CPT Codes

86790CPT Code

West Nile virus antibody test

Clinical Scenario

Used when serological testing is performed to confirm infection.

Documentation Requirements

Document the reason for testing and any relevant clinical findings.

Specialty Considerations

Infectious disease specialists may require additional details on exposure history.

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 infections, improving the accuracy of epidemiological data and enhancing the ability to track outbreaks and manage public health responses.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of West Nile virus infections, improving the accuracy of epidemiological data and enhancing the ability to track outbreaks and manage public health responses.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of West Nile virus infections, improving the accuracy of epidemiological data and enhancing the ability to track outbreaks and manage public health responses.

Resources

Clinical References

  • •
    CDC West Nile Virus Information

Coding & Billing References

  • •
    CDC West Nile Virus Information

Frequently Asked Questions

What symptoms should be documented for West Nile virus infection?

Symptoms may include fever, headache, body aches, joint pain, vomiting, diarrhea, rash, and neurological signs such as confusion or weakness. Documenting the severity and duration of symptoms is crucial.

How important is travel history in coding for West Nile virus?

Travel history is essential as it helps establish potential exposure to the virus, especially if the patient has traveled to endemic areas. This information supports the diagnosis and coding accuracy.