ICD-10 B19.21
Billable / Specific MCCUnspecified viral hepatitis C with hepatic coma
About ICD-10-CM B19.21
ICD-10-CM code B19.21 represents Unspecified viral hepatitis C with hepatic coma. This is a billable/specific code in the Infectious and Parasitic Diseases chapter (block B19). The 2026 edition of ICD-10-CM B19.21 became effective on October 1, 2025.
Coding Tips for B19.21
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
B19.21 is designated MCC for MS-DRG grouping. On inpatient claims, this code can shift the DRG to the with-MCC variant when documented as a present-on-admission secondary diagnosis. Hospital CDI programs flag MCC opportunities during chart review. Failure to capture this code may leave 30 to 80 percent of the inpatient stay revenue unrealized.
Inpatient DRG Impact, MCC
codes Unspecified viral hepatitis C with hepatic coma. As a Major Complication/Comorbidity (MCC), this can shift the DRG assignment to a higher-weighted category, substantial reimbursement impact.
Medicare LCD Coverage for B19.21
Local Coverage Determinations (LCDs) from CMS MACs that list B19.21 as a covered diagnosis.
Showing top 10 of 25 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing B19.21.
3 Aetna
3 Medicare
CPT Codes Commonly Billed with B19.21
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
- Q4081 CMS LCD: Billing and Coding: Erythropoiesis Stimulating Agents (ESA) CMS LCD
- J0881 CMS LCD: Billing and Coding: Erythropoiesis Stimulating Agents (ESA) CMS LCD
- Q5106 CMS LCD: Billing and Coding: Erythropoiesis Stimulating Agents (ESA) CMS LCD
- J0882 CMS LCD: Billing and Coding: Erythropoiesis Stimulating Agents (ESA) CMS LCD
- J0885 CMS LCD: Billing and Coding: Erythropoiesis Stimulating Agents (ESA) CMS LCD
- Q5105 CMS LCD: Billing and Coding: Erythropoiesis Stimulating Agents (ESA) CMS LCD
- J0890 CMS LCD: Billing and Coding: Erythropoiesis Stimulating Agents (ESA) CMS LCD
Convert B19.21 to ICD-9-CM
Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.
| ICD-10 | ICD-9 | Mapping Flags |
|---|---|---|
| B19.21 | 07071 | 00000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To B19.21
Other codes in section B15-B19 (Viral hepatitis).
ICD-10 B19.21, Billing FAQ
Is ICD-10 code B19.21 billable? +
Yes, B19.21 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
Is B19.21 a CC or MCC for inpatient DRG? +
Yes, this code is designated as MCC. Documenting as a secondary diagnosis on inpatient claims can shift the DRG to a higher-weighted category.
What CPT codes are commonly billed with B19.21? +
Procedures frequently paired with B19.21 include: Q4081, J0881, Q5106, J0882, J0885.
What ICD-9 codes does B19.21 map to? +
Per CMS GEMs, B19.21 maps to ICD-9 codes: 07071. Useful for legacy data review and historical claim analysis.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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