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v1.0.0
ICD-10 Guide
ICD-10 CodesB06.8

B06.8

Other specified acute upper respiratory infections

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

Code Description

ICD-10 B06.8 is a billable code used to indicate a diagnosis of other specified acute upper respiratory infections.

Key Diagnostic Point:

B06.8 encompasses a variety of acute upper respiratory infections that do not fall under more specific categories. These infections are typically viral in nature and can include conditions such as viral pharyngitis, viral laryngitis, and other unspecified viral upper respiratory infections. Symptoms often include sore throat, cough, nasal congestion, and fever. The diagnosis is primarily clinical, based on patient history and physical examination, as laboratory tests are not routinely required. Vaccination considerations are important, particularly for influenza and COVID-19, as these can complicate or exacerbate the symptoms of other upper respiratory infections. Complications may arise, such as secondary bacterial infections, which can lead to conditions like sinusitis or otitis media. Accurate coding is essential for proper treatment and management of these infections, as well as for tracking epidemiological trends.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of viral pathogens that can cause similar symptoms
  • Overlap with other respiratory infection codes
  • Need for thorough documentation to specify the type of infection
  • Potential for complications that may require additional coding

Audit Risk Factors

  • Inadequate documentation of symptoms and clinical findings
  • Misclassification of viral infections as bacterial
  • Failure to document vaccination status
  • Inconsistent coding practices among providers

Specialty Focus

Medical Specialties

Primary Care

Documentation Requirements

Detailed patient history, symptom description, and any relevant lab results.

Common Clinical Scenarios

Patients presenting with cough, sore throat, and fever during cold and flu season.

Billing Considerations

Ensure to document any vaccination history and potential complications.

Pediatrics

Documentation Requirements

Growth charts, vaccination status, and detailed symptomatology.

Common Clinical Scenarios

Children with acute respiratory symptoms, especially during viral outbreaks.

Billing Considerations

Consider age-specific guidelines for treatment and documentation.

Coding Guidelines

Inclusion Criteria

Use B06.8 When
  • Follow the official ICD
  • CM guidelines for coding respiratory infections, ensuring to document the specific type of infection and any associated symptoms

Exclusion Criteria

Do NOT use B06.8 When
  • Exclude codes for more specific infections unless they are also present

Related CPT Codes

99213CPT Code

Established patient office visit, Level 3

Clinical Scenario

Used for follow-up visits for patients with upper respiratory infections.

Documentation Requirements

Document the patient's history, examination findings, and treatment plan.

Specialty Considerations

Ensure to include any relevant vaccination history.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of respiratory infections, improving data accuracy and patient management. B06.8 provides flexibility for coders to capture a range of viral infections that may not have been specified in ICD-9.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of respiratory infections, improving data accuracy and patient management. B06.8 provides flexibility for coders to capture a range of viral infections that may not have been specified in ICD-9.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of respiratory infections, improving data accuracy and patient management. B06.8 provides flexibility for coders to capture a range of viral infections that may not have been specified in ICD-9.

Resources

Clinical References

  • •
    CDC - Viral Respiratory Infections

Coding & Billing References

  • •
    CDC - Viral Respiratory Infections

Frequently Asked Questions

What symptoms are associated with B06.8?

Symptoms include sore throat, cough, nasal congestion, and fever, typically associated with viral infections.

When should I use B06.8 instead of a more specific code?

Use B06.8 when the specific viral infection is not identified or documented, and the symptoms align with acute upper respiratory infections.