ICD-10 Guide

Herpes Simplex Virus

ICD-10 Coding for Herpes Simplex Virus(B00.0, B00.1)

PRIMARY SPECIALTYDentistry

COMPLEXITYHigh

LAST UPDATED09/15/2025

Sam Tuffun, PT, DPT

Physical Therapist | Medical Coding & Billing Contributor

Diagnosis Overview

What is Herpes Simplex Virus?

Essential facts and insights about Herpes Simplex Virus

Key Clinical Considerations:

Painful vesicular lesions on the oral mucosa and lips
PCR testing for HSV DNA, viral culture, or serological tests for HSV antibodies
Erythema, swelling, and ulceration in the affected areas

Clinical Information

Clinical Criteria & Documentation Requirements

Patient history of previous outbreaks, current symptoms, and duration
Use of specific ICD-10 codes for herpes simplex virus
Examples include noting the location of lesions and patient response to treatment

Coding Guidelines

Usage Guidelines & Examples

Follow guidelines for distinguishing between oral and genital herpes
Common errors include using outdated codes or incorrect site-specific codes

Code Exclusions

Important Exclusions

Other viral infections of the oral cavity
Alternative codes for herpes zoster or other herpes viruses

Specialty Focus

Primary Specialty

Dentistry

Specialty Applications

Patients with recurrent oral herpes outbreaks
Dental clinics and oral health specialists

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

Documentation requirements?

Include patient history, clinical findings, and treatment plan.

Billing considerations?

Ensure correct ICD-10 codes are used to avoid claim denials.

Herpes Simplex Virus

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

Documentation requirements?

Billing considerations?

Herpes Simplex Virus

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

Documentation requirements?

Billing considerations?