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v1.0.0
ICD-10 Guide
ICD-10 CodesB19.1

B19.1

Unspecified viral hepatitis C

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

Code Description

ICD-10 B19.1 is a billable code used to indicate a diagnosis of unspecified viral hepatitis c.

Key Diagnostic Point:

Unspecified viral hepatitis C refers to a liver infection caused by the hepatitis C virus (HCV) that has not been classified into a specific subtype or stage. Hepatitis C is primarily transmitted through blood-to-blood contact, often via sharing needles or other equipment to inject drugs, and less commonly through sexual contact or from mother to child during childbirth. The infection can be acute or chronic, with chronic hepatitis C potentially leading to severe liver complications such as cirrhosis, liver failure, and hepatocellular carcinoma. Patients may remain asymptomatic for years, making screening and early detection crucial. Management of chronic hepatitis C includes antiviral therapy, which can lead to sustained virologic response (SVR), effectively curing the infection. Regular monitoring for liver function and complications is essential in chronic cases, as well as lifestyle modifications to reduce liver strain. Given the complexities of hepatitis C, including its various genotypes and treatment regimens, accurate coding is vital for appropriate patient management and reimbursement.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and symptoms
  • Need for differentiation between acute and chronic hepatitis C
  • Potential for co-infection with other hepatitis viruses
  • Complexity of treatment regimens and monitoring requirements

Audit Risk Factors

  • Inadequate documentation of patient history and risk factors
  • Failure to specify acute vs. chronic status
  • Lack of follow-up documentation for chronic management
  • Misclassification of hepatitis type or subtype

Specialty Focus

Medical Specialties

Gastroenterology

Documentation Requirements

Detailed history of liver function tests, imaging studies, and treatment plans.

Common Clinical Scenarios

Patients presenting with elevated liver enzymes, jaundice, or complications from chronic hepatitis C.

Billing Considerations

Ensure documentation reflects the chronicity of the disease and any associated liver complications.

Infectious Disease

Documentation Requirements

Thorough documentation of risk factors, laboratory results, and treatment response.

Common Clinical Scenarios

Patients with acute hepatitis C seeking treatment or those with chronic infection undergoing antiviral therapy.

Billing Considerations

Document any co-infections or complications that may affect treatment decisions.

Coding Guidelines

Inclusion Criteria

Use B19.1 When
  • According to ICD
  • 10 coding guidelines, B19
  • 1 should be used when the specific type of hepatitis C is not documented
  • Coders should ensure that the documentation supports the diagnosis and that any acute or chronic status is clearly indicated

Exclusion Criteria

Do NOT use B19.1 When
No specific exclusions found.

Related CPT Codes

86803CPT Code

HCV antibody test

Clinical Scenario

Used for initial screening of hepatitis C infection.

Documentation Requirements

Document the reason for testing and any relevant patient history.

Specialty Considerations

Gastroenterology and Infectious Disease specialists should ensure comprehensive documentation of risk factors.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of hepatitis C, improving the ability to track and manage the disease. B19.1 provides a way to capture unspecified cases, which can help in understanding the epidemiology of hepatitis C.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of hepatitis C, improving the ability to track and manage the disease. B19.1 provides a way to capture unspecified cases, which can help in understanding the epidemiology of hepatitis C.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of hepatitis C, improving the ability to track and manage the disease. B19.1 provides a way to capture unspecified cases, which can help in understanding the epidemiology of hepatitis C.

Resources

Clinical References

  • •
    CDC Hepatitis C Information

Coding & Billing References

  • •
    CDC Hepatitis C Information

Frequently Asked Questions

What does unspecified viral hepatitis C mean?

Unspecified viral hepatitis C indicates that the specific subtype or stage of hepatitis C has not been documented, requiring careful consideration of the patient's history and clinical findings for accurate coding.