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v1.0.0
ICD-10 Guide
DiagnosesHerpes Zoster Shingles

Herpes Zoster Shingles

ICD-10 Coding for Herpes Zoster (Shingles)(B02.9, B02.3)

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

Diagnosis Overview

What is Herpes Zoster Shingles?
Essential facts and insights about Herpes Zoster (Shingles)

Key Clinical Considerations:

  • Painful rash with vesicular lesions typically localized to a dermatomal distribution
  • Positive Tzanck smear showing multinucleated giant cells or PCR testing for VZV
  • Unilateral vesicular rash, tenderness, and dermatomal pain on physical examination

Clinical Information

Clinical Criteria & Documentation Requirements

  • Patient history of varicella (chickenpox) infection or vaccination
  • Use of specific terminology such as 'herpes zoster' or 'shingles'
  • Examples include documenting the location, severity of pain, and duration of symptoms

Coding Guidelines

Usage Guidelines & Examples

  • Follow guidelines for distinguishing between uncomplicated and complicated zoster.
  • Common errors include misclassifying the type of zoster or failing to document complications.

Code Exclusions

Important Exclusions

  • Conditions such as chickenpox (B01.9) and postherpetic neuralgia (G53.0).
  • Alternative codes for complications like ophthalmic zoster (B02.2).

Related ICD-10 Codes

Primary Codes
B02.9
Zoster (herpes zoster) without complications
B02.1
Zoster with other complications
Ancillary Codes
Z23
Differential Codes
B00.9
B02.9
for dermatomal rash and positive VZV PCR.
H16.9
B02.3
when VZV is confirmed.

Related CPT Codes

CPT codes will be available in a future update.

Specialty Focus

Primary Specialty

General Practice

Specialty Applications

  • Adults over 50 years, immunocompromised patients, and those with a history of varicella.
  • General practice, urgent care, and dermatology 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

Documentation requirements?

Document the patient's history, symptoms, and physical exam findings.

Billing considerations?

Ensure accurate coding to reflect the severity and complications for appropriate reimbursement.