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ICD-10 Guide
ICD-10 CodesB19.20

B19.20

Unspecified viral hepatitis C without hepatic coma

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

Code Description

ICD-10 B19.20 is a billable code used to indicate a diagnosis of unspecified viral hepatitis c without hepatic coma.

Key Diagnostic Point:

Unspecified viral hepatitis C without hepatic coma refers to a chronic infection caused by the hepatitis C virus (HCV), which primarily affects the liver. This condition can lead to inflammation and damage to liver cells, potentially resulting in chronic liver disease. Patients may be asymptomatic or present with mild symptoms such as fatigue, malaise, and jaundice. The transmission of HCV occurs primarily through blood-to-blood contact, which can happen through sharing needles, transfusions of unscreened blood products, or from mother to child during childbirth. Chronic management of hepatitis C involves antiviral therapy, which aims to achieve a sustained virologic response (SVR), indicating that the virus is no longer detectable in the blood. Regular monitoring for liver function and complications, such as cirrhosis or hepatocellular carcinoma, is essential. The absence of hepatic coma indicates that the patient is not experiencing severe liver failure, which can complicate the clinical picture. Proper coding for this condition is crucial for appropriate treatment and reimbursement.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation and symptoms
  • Need for detailed patient history to determine chronicity
  • Potential for co-infection with other hepatitis viruses
  • Differentiation from acute hepatitis C

Audit Risk Factors

  • Inadequate documentation of symptoms and history
  • Failure to document liver function tests
  • Misclassification of acute vs. chronic hepatitis
  • Lack of follow-up care documentation

Specialty Focus

Medical Specialties

Hepatology

Documentation Requirements

Detailed liver function tests, imaging results, and treatment plans must be documented.

Common Clinical Scenarios

Patients presenting with chronic hepatitis C, monitoring for liver disease progression.

Billing Considerations

Consideration of co-morbid conditions and potential drug interactions with antiviral therapy.

Infectious Disease

Documentation Requirements

History of exposure, laboratory results confirming HCV infection, and treatment response.

Common Clinical Scenarios

Management of patients with chronic hepatitis C and potential co-infections.

Billing Considerations

Awareness of the latest antiviral therapies and their side effects.

Coding Guidelines

Inclusion Criteria

Use B19.20 When
  • According to ICD
  • 10 coding guidelines, B19
  • 20 should be used when the specific type of viral hepatitis C is not documented
  • It is essential to ensure that the documentation supports the diagnosis and that there is no indication of hepatic coma

Exclusion Criteria

Do NOT use B19.20 When
No specific exclusions found.

Related CPT Codes

86803CPT Code

HCV antibody test

Clinical Scenario

Used for initial diagnosis of hepatitis C.

Documentation Requirements

Document the reason for testing and results.

Specialty Considerations

Hepatology and Infectious Disease specialists should ensure accurate interpretation of results.

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 accuracy of diagnosis and treatment tracking. B19.20 provides a clear designation for unspecified chronic hepatitis C, facilitating better patient management.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of hepatitis C, improving the accuracy of diagnosis and treatment tracking. B19.20 provides a clear designation for unspecified chronic hepatitis C, facilitating better patient management.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of hepatitis C, improving the accuracy of diagnosis and treatment tracking. B19.20 provides a clear designation for unspecified chronic hepatitis C, facilitating better patient management.

Resources

Clinical References

  • •
    CDC Hepatitis C Information

Coding & Billing References

  • •
    CDC Hepatitis C Information

Frequently Asked Questions

What is the difference between B19.20 and B19.21?

B19.20 is used for unspecified chronic hepatitis C, while B19.21 is for acute hepatitis C. The clinical management and implications of these conditions differ significantly.