ICD-10 Guide

Herpes Simplex 1

ICD-10 Coding for Herpes Simplex Virus 1(B00.1, B00.2)

PRIMARY SPECIALTYFamily Medicine

COMPLEXITYHigh

LAST UPDATED09/15/2025

Sam Tuffun, PT, DPT

Physical Therapist | Medical Coding & Billing Contributor

Diagnosis Overview

What is Herpes Simplex 1?

Essential facts and insights about Herpes Simplex Virus 1

Key Clinical Considerations:

Painful vesicular lesions on lips or oral mucosa
Positive viral culture or PCR for HSV-1
Localized erythema and swelling in affected areas

Clinical Information

Clinical Criteria & Documentation Requirements

Patient history of previous outbreaks
Description of lesions and symptoms
Confirmation of diagnosis through lab tests

Coding Guidelines

Usage Guidelines & Examples

Follow ICD-10 guidelines for specificity.
Common errors include using incorrect codes for HSV-2.

Code Exclusions

Important Exclusions

Herpes simplex virus type 2 (B00.3)
Other viral infections causing similar symptoms

Specialty Focus

Primary Specialty

Family Medicine

Specialty Applications

Adults and children with oral herpes
Family medicine 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 patient history, symptoms, and lab results.

What are the billing considerations?

Ensure accurate coding to reflect the diagnosis and any associated procedures.

Herpes Simplex 1

Diagnosis Overview

Key Clinical Considerations:

Clinical Information

Clinical Criteria & Documentation Requirements

Coding Guidelines

Usage Guidelines & Examples

Code Exclusions

Important Exclusions

Related ICD-10 Codes

Related CPT Codes

Specialty Focus

Primary Specialty

Specialty Applications

Coding Complexity

Documentation

Documentation Templates

Billing Information

Billing Considerations

Common Issues

Frequently Asked Questions

What are the documentation requirements?

What are the billing considerations?

Herpes Simplex 1

Diagnosis Overview

Key Clinical Considerations:

Clinical Information

Clinical Criteria & Documentation Requirements

Coding Guidelines

Usage Guidelines & Examples

Code Exclusions

Important Exclusions

Related ICD-10 Codes

Related CPT Codes

Specialty Focus

Primary Specialty

Specialty Applications

Coding Complexity

Documentation

Documentation Templates

Billing Information

Billing Considerations

Common Issues

Frequently Asked Questions

What are the documentation requirements?

What are the billing considerations?