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v1.0.0
ICD-10 Guide
ICD-10 CodesA92.9

A92.9

West Nile virus infection, unspecified

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

Code Description

ICD-10 A92.9 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 cases to severe neurological diseases such as encephalitis or meningitis. Symptoms typically include fever, headache, body aches, and in severe cases, neurological symptoms such as confusion, seizures, or paralysis. The infection is most prevalent in areas where the virus is endemic, particularly during warmer months when mosquito populations are high. Diagnosis is often based on clinical presentation, travel history to endemic areas, and serological testing for West Nile virus-specific antibodies. Given the potential for severe outcomes, timely recognition and reporting of cases are crucial for public health monitoring and response. The unspecified nature of this code indicates that the clinician has not documented the specific type or severity of the infection, which may complicate treatment and management strategies.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and severity of the infection.
  • Need for travel history documentation to establish exposure risk.
  • Differentiation from other arboviral infections such as Zika or dengue.
  • Potential for co-infection with other pathogens.

Audit Risk Factors

  • Inadequate documentation of travel history.
  • Failure to specify the severity of the infection.
  • Misclassification of symptoms leading to incorrect coding.
  • Lack of follow-up documentation for confirmed cases.

Specialty Focus

Medical Specialties

Infectious Disease

Documentation Requirements

Detailed patient history including travel, exposure, and symptom onset.

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.

Emergency Medicine

Documentation Requirements

Accurate recording of presenting symptoms and travel history.

Common Clinical Scenarios

Patients with acute febrile illness and recent travel to areas with reported West Nile virus activity.

Billing Considerations

Rapid assessment and documentation to facilitate timely diagnosis and treatment.

Coding Guidelines

Inclusion Criteria

Use A92.9 When
  • According to ICD
  • 10 coding guidelines, A92
  • 9 should be used when the specific type of West Nile virus infection is not documented
  • Coders should ensure that all relevant clinical information is captured to support the use of this code

Exclusion Criteria

Do NOT use A92.9 When
No specific exclusions found.

Related CPT Codes

86788CPT Code

West Nile virus antibody test

Clinical Scenario

Used when serological testing is performed to confirm West Nile virus infection.

Documentation Requirements

Document the reason for testing and any relevant clinical findings.

Specialty Considerations

Infectious disease specialists should ensure comprehensive documentation of clinical context.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of viral infections, including West Nile virus. This has improved the ability to track and manage outbreaks and has enhanced the granularity of data for public health reporting.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of viral infections, including West Nile virus. This has improved the ability to track and manage outbreaks and has enhanced the granularity of data for public health reporting.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of viral infections, including West Nile virus. This has improved the ability to track and manage outbreaks and has enhanced the granularity of data for public health reporting.

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, and in severe cases, neurological symptoms such as confusion, seizures, or paralysis.

How is West Nile virus diagnosed?

Diagnosis is typically made through serological testing for West Nile virus-specific antibodies or PCR testing of cerebrospinal fluid in cases of neurological involvement.