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ICD-10 Guide
ICD-10 CodesB97

B97

Viral agents as the cause of diseases classified elsewhere

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

Code Description

ICD-10 B97 is a used to indicate a diagnosis of viral agents as the cause of diseases classified elsewhere.

Key Diagnostic Point:

ICD-10 Category B97 encompasses viral agents that are identified as the underlying cause of diseases classified elsewhere in the ICD-10 coding system. This category is crucial for accurately attributing the etiology of various viral infections, such as the respiratory syncytial virus (RSV), which can lead to significant respiratory conditions, particularly in infants and the elderly. By coding these viral agents, healthcare providers can ensure appropriate treatment and management strategies are implemented, as well as facilitate epidemiological tracking of viral diseases and their impacts on public health.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of viral agents
  • Overlap with other disease classifications
  • Need for precise clinical documentation

Audit Risk Factors

  • Inaccurate coding of viral etiology
  • Insufficient clinical documentation
  • Misinterpretation of viral impact on primary diagnoses

Specialty Focus

Medical Specialties

Infectious Disease

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Pediatrics

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Related Codes

Child Codes

24 codes
B97.0
COVID-19, virus not identified
B97.1
Enterovirus as the cause of diseases classified elsewhere
B97.10
Unspecified enterovirus as the cause of diseases classified elsewhere
B97.11
Coxsackievirus as the cause of diseases classified elsewhere
B97.12
Echovirus as the cause of diseases classified elsewhere
B97.19
Other enterovirus as the cause of diseases classified elsewhere
B97.2
Coronavirus as the cause of diseases classified elsewhere
B97.21
SARS-associated coronavirus as the cause of diseases classified elsewhere
B97.29
Other coronavirus as the cause of diseases classified elsewhere
B97.3
Coronavirus as the cause of diseases classified elsewhere
B97.30
Unspecified retrovirus as the cause of diseases classified elsewhere
B97.31
Lentivirus as the cause of diseases classified elsewhere
B97.32
Oncovirus as the cause of diseases classified elsewhere
B97.33
Human T-cell lymphotrophic virus, type I [HTLV-I] as the cause of diseases classified elsewhere
B97.34
Human T-cell lymphotrophic virus, type II [HTLV-II] as the cause of diseases classified elsewhere
B97.35
Human immunodeficiency virus, type 2 [HIV 2] as the cause of diseases classified elsewhere
B97.39
Other retrovirus as the cause of diseases classified elsewhere
B97.4
COVID-19, virus not identified
B97.5
Papillomavirus as the cause of diseases classified elsewhere
B97.6
Respiratory syncytial virus (RSV) as the cause of diseases classified elsewhere
B97.7
Coronavirus as the cause of diseases classified elsewhere
B97.8
Other viral agents as the cause of diseases classified elsewhere
B97.81
Human metapneumovirus as the cause of diseases classified elsewhere
B97.89
Other viral agents as the cause of diseases classified elsewhere

Related CPT Codes

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The clinical impact of B97 is significant as it allows for the identification and management of viral infections that can complicate other health conditions. From an administrative perspective, accurate coding under B97 contributes to better population health data, enabling healthcare systems to track viral disease trends and allocate resources effectively. Additionally, the use of B97 codes can influence quality measures and healthcare outcomes, as understanding the viral etiology of diseases can lead to improved patient care strategies and public health interventions.

ICD-9 vs ICD-10

The clinical impact of B97 is significant as it allows for the identification and management of viral infections that can complicate other health conditions. From an administrative perspective, accurate coding under B97 contributes to better population health data, enabling healthcare systems to track viral disease trends and allocate resources effectively. Additionally, the use of B97 codes can influence quality measures and healthcare outcomes, as understanding the viral etiology of diseases can lead to improved patient care strategies and public health interventions.

Reimbursement & Billing Impact

Reimbursement considerations include the necessity of providing comprehensive clinical information that links the viral agent to the presenting illness. Common billing practices involve ensuring that the B97 code is used in conjunction with the primary diagnosis code to reflect the full clinical picture, which is essential for accurate claims processing and reimbursement.

Resources

Clinical References

  • •
    Official ICD-10 Guidelines for B97

Coding & Billing References

  • •
    Official ICD-10 Guidelines for B97

Frequently Asked Questions

What conditions are included in B97?

B97 includes various viral agents such as respiratory syncytial virus (RSV), adenovirus, and others that are documented as the cause of diseases classified in other categories. It is important to refer to specific guidelines to determine the exact conditions covered.

When should I use B97 codes?

B97 codes should be used when a viral agent is confirmed as the cause of a disease that is classified elsewhere. This includes situations where the viral infection is documented in the patient's medical record and is relevant to the treatment and management of the patient's condition.

What documentation is required for B97?

Documentation must include a clear indication of the viral agent's role in the patient's condition, including laboratory results, clinical findings, and any relevant history that supports the diagnosis of a viral infection as the underlying cause.