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v1.0.0
ICD-10 Guide
DiagnosesHerpes Simplex

Herpes Simplex

ICD-10 Coding for Herpes Simplex(B00.1, A60.04)

PRIMARY SPECIALTYDermatology
COMPLEXITYHigh
LAST UPDATED09/15/2025
Sam Tuffun, PT, DPT
Physical Therapist | Medical Coding & Billing Contributor

Diagnosis Overview

What is Herpes Simplex?
Essential facts and insights about Herpes Simplex

Key Clinical Considerations:

  • Painful vesicular lesions on the skin or mucous membranes
  • Positive viral culture or PCR test for HSV
  • Erythema and swelling in the affected area

Clinical Information

Clinical Criteria & Documentation Requirements

  • Patient history of previous outbreaks
  • Description of lesions (location, size, appearance)
  • Results of laboratory tests confirming HSV

Coding Guidelines

Usage Guidelines & Examples

  • Use B00.1 for unspecified infections; B00.2 for specific skin and mucous membrane infections.
  • Common errors include using incorrect codes for recurrent infections.

Code Exclusions

Important Exclusions

  • Herpes zoster (shingles)
  • Other viral infections of the skin

Related ICD-10 Codes

Primary Codes
B00.1
Herpes simplex virus infection, unspecified
B00.2
Herpes simplex virus infection of the skin and mucous membranes
Ancillary Codes
Z11.3
O98.31x
Differential Codes
L30.3
B00.1
B00.1
for facial/oral lesions.

Related CPT Codes

CPT codes will be available in a future update.

Specialty Focus

Primary Specialty

Dermatology

Specialty Applications

  • Patients with a history of herpes simplex outbreaks
  • Dermatology clinics, urgent care centers, and primary care settings

Coding Complexity

High Complexity

This diagnosis requires careful attention to:

  • Comprehensive clinical documentation
  • Accurate code selection based on clinical criteria
  • Proper exclusion considerations
  • Specialty-specific coding guidelines

Documentation

Documentation Templates

Billing Information

Billing Considerations

  • Ensure proper documentation for billing
  • Verify code specificity requirements
  • Check for any additional codes needed
  • Review payer-specific guidelines

Common Issues

  • Insufficient clinical documentation
  • Incorrect code selection
  • Missing supporting diagnoses
  • Timing and frequency documentation

Frequently Asked Questions

What are the documentation requirements?

Document the type, location, and duration of lesions, along with any relevant patient history.

What are the billing considerations?

Ensure accurate coding based on the specific type of herpes simplex infection and associated symptoms.