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ICD-10 Guide
ICD-10 CodesB01.9

B01.9

Varicella without complication

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

Code Description

ICD-10 B01.9 is a billable code used to indicate a diagnosis of varicella without complication.

Key Diagnostic Point:

Varicella, commonly known as chickenpox, is a highly contagious viral infection caused by the varicella-zoster virus (VZV). It is characterized by an itchy rash that develops into fluid-filled blisters, fever, fatigue, and loss of appetite. The rash typically appears in stages, starting as small red spots that progress to vesicles and eventually crust over. While varicella is generally a mild illness in healthy children, it can lead to complications such as bacterial infections of the skin, pneumonia, and encephalitis in immunocompromised individuals or adults. The condition is preventable through vaccination, with the varicella vaccine recommended for children, adolescents, and adults who have not had the disease. Vaccination not only reduces the incidence of varicella but also mitigates the risk of complications associated with the infection. In cases coded as B01.9, the absence of complications indicates that the patient is experiencing a typical case of varicella without any severe manifestations or secondary infections. Accurate coding is essential for proper treatment and reimbursement, as well as for tracking the incidence of this vaccine-preventable disease.

Code Complexity Analysis

Complexity Rating: Low

Low Complexity

Complexity Factors

  • Clear clinical definition of the condition
  • Standardized diagnostic criteria
  • Well-established treatment protocols
  • Commonly encountered in pediatric populations

Audit Risk Factors

  • Inaccurate documentation of complications
  • Misclassification of varicella as a complication
  • Failure to document vaccination status
  • Inconsistent coding practices among providers

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Documentation should include patient history, vaccination status, and clinical findings related to the varicella rash.

Common Clinical Scenarios

Routine visits for vaccination, acute presentations of varicella, and follow-up visits for rash management.

Billing Considerations

Ensure that vaccination history is documented to support the diagnosis and coding.

Infectious Disease

Documentation Requirements

Detailed clinical notes on the patient's immune status and any potential complications should be included.

Common Clinical Scenarios

Consultations for complicated varicella cases or immunocompromised patients.

Billing Considerations

Focus on the patient's overall health status and any underlying conditions that may affect the course of the disease.

Coding Guidelines

Inclusion Criteria

Use B01.9 When
  • According to ICD
  • 10 guidelines, B01
  • 9 should be used when a patient presents with varicella without any documented complications
  • It is important to ensure that the diagnosis is confirmed and that the condition is not a result of a secondary infection or other complications

Exclusion Criteria

Do NOT use B01.9 When
No specific exclusions found.

Related CPT Codes

90710CPT Code

Varicella virus vaccine

Clinical Scenario

Administering the varicella vaccine to a child during a routine visit.

Documentation Requirements

Document the vaccine administration, including date, dosage, and patient consent.

Specialty Considerations

Pediatricians should ensure that vaccination records are up to date.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of varicella cases, improving data accuracy and enhancing the ability to track vaccination rates and disease incidence.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of varicella cases, improving data accuracy and enhancing the ability to track vaccination rates and disease incidence.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of varicella cases, improving data accuracy and enhancing the ability to track vaccination rates and disease incidence.

Resources

Clinical References

  • •
    CDC Varicella (Chickenpox) Information

Coding & Billing References

  • •
    CDC Varicella (Chickenpox) Information

Frequently Asked Questions

What is the difference between B01.9 and B01.0?

B01.9 is used for varicella without complications, while B01.0 is for cases where complications such as pneumonia or encephalitis are present. Accurate documentation is crucial for proper coding.