ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 B20

Billable / Specific HCC v28: 1 CC

Human immunodeficiency virus [HIV] disease

B20
Block
0
Synonyms
1,299
LCDs
55
Payer Policies
207
Linked CPTs

About ICD-10-CM B20

ICD-10-CM code B20 represents Human immunodeficiency virus [HIV] disease. This is a billable/specific code in the Infectious and Parasitic Diseases chapter (block B20). The 2026 edition of ICD-10-CM B20 became effective on October 1, 2025.

Coding Tips for B20

Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.

HCC capture: document with MEAT each year

B20 is a CMS-HCC v28 risk-adjustment code (category 1). To count for the patient Risk Adjustment Factor (RAF), document the diagnosis with MEAT language each calendar year: Monitored, Evaluated, Assessed, Treated. A diagnosis on the problem list alone does not satisfy CMS RADV audit standards. Include the diagnosis in the assessment with current status and current treatment plan.

Inpatient DRG impact: CC

B20 is designated CC for MS-DRG grouping. On inpatient claims, this code can shift the DRG to the with-CC variant when documented as a present-on-admission secondary diagnosis. Hospital CDI programs flag CC opportunities during chart review. Failure to capture this code may leave 30 to 80 percent of the inpatient stay revenue unrealized.

Type 1 Excludes

Pure excludes, these codes can never be coded together with B20. The conditions are mutually exclusive (e.g., congenital vs acquired forms).

  • asymptomatic human immunodeficiency virus [HIV] infection status (Z21)
  • exposure to HIV virus (Z20.6)
  • inconclusive serologic evidence of HIV (R75)

Includes

  • acquired immune deficiency syndrome [AIDS]
  • AIDS-related complex [ARC]
  • HIV infection, symptomatic

Use Additional Code

When coding B20, also report these additional codes when applicable.

  • code(s) to identify all manifestations of HIV infection

Coding Notes

Code First

  • Human immunodeficiency virus [HIV] disease complicating pregnancy, childbirth and the puerperium, if applicable (O98.7-)

Medicare Advantage HCC Impact

CMS-HCC v28 (current)
Category 1
ESRD-HCC
Category 1
RxHCC (Part D)
Category 1

Capture this diagnosis annually for accurate risk adjustment. Missed HCC captures are the #1 revenue leak in Medicare Advantage risk programs.

Inpatient DRG Impact, CC

codes Human immunodeficiency virus [HIV] disease. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.

Medicare LCD Coverage for B20

Local Coverage Determinations (LCDs) from CMS MACs that list B20 as a covered diagnosis.

1,299 LCDs

Showing top 10 of 1,299 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Ophthalmology: Extended Ophthalmoscopy and Fundus Photography
Article ID: 53060, Effective: 2025-10-01 00:00:00, 1692 covered, 0 non-covered
CPT 92201 →
CMS LCD: Billing and Coding: Ophthalmology: Extended Ophthalmoscopy and Fundus Photography
Article ID: 53060, Effective: 2025-10-01 00:00:00, 1692 covered, 0 non-covered
CPT 92250 →
CMS LCD: Billing and Coding: Ophthalmology: Extended Ophthalmoscopy and Fundus Photography
Article ID: 53060, Effective: 2025-10-01 00:00:00, 1692 covered, 0 non-covered
CPT 92202 →
CMS LCD: Billing and Coding: Ophthalmology: Extended Ophthalmoscopy and Fundus Photography
Article ID: 53060, Effective: 2025-10-01 00:00:00, 1692 covered, 0 non-covered
CPT 92227 →
CMS LCD: Billing and Coding: Ophthalmology: Extended Ophthalmoscopy and Fundus Photography
Article ID: 53060, Effective: 2025-10-01 00:00:00, 1692 covered, 0 non-covered
CPT 92228 →
CMS LCD: Billing and Coding: Respiratory Care
Article ID: 57224, Effective: 2026-01-01 00:00:00, 901 covered, 0 non-covered
CPT 94660 →
CMS LCD: Billing and Coding: Respiratory Care
Article ID: 57224, Effective: 2026-01-01 00:00:00, 901 covered, 0 non-covered
CPT 94726 →
CMS LCD: Billing and Coding: Respiratory Care
Article ID: 57224, Effective: 2026-01-01 00:00:00, 901 covered, 0 non-covered
CPT 94664 →
CMS LCD: Billing and Coding: Respiratory Care
Article ID: 57224, Effective: 2026-01-01 00:00:00, 901 covered, 0 non-covered
CPT 94618 →
CMS LCD: Billing and Coding: Respiratory Care
Article ID: 57224, Effective: 2026-01-01 00:00:00, 901 covered, 0 non-covered
CPT 94772 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing B20.

55 policies

3 Aetna

Hepatitis A Vaccine - Medical Clinical Policy Bulletins | Aetna
Policy ID: CPB-0048
Hematopoietic Colony-Stimulating Factors (CSFs) - Medical Clinical Policy Bulletins | Aetna
Policy ID: CPB-0055
Nebulizers - Medical Clinical Policy Bulletins | Aetna
Policy ID: CPB-0065

5 Cigna

Electrodiagnostic Testing (EMG/NCV) - (CPG129)
Policy ID: CPG129_EMG_NCV_SSEP
Flow Cytometry - (0538)
Policy ID: MM_0538
Neuropsychological Testing - (EN0258)
Policy ID: EN_MM_0258
Nucleic Acid Pathogen Testing - (0530)
Policy ID: MM_0530
Transthoracic Echocardiography in Children - (0523)
Policy ID: MM_0523

5 Medicare

Nebulizers - Policy Article
Policy ID: ART-52466
Billing and Coding: Routine Foot Care
Policy ID: ART-52996
Billing and Coding: Ophthalmology: Extended Ophthalmoscopy and Fundus Photography
Policy ID: ART-53060
Billing and Coding: Lab: Flow Cytometry
Policy ID: ART-55717
Billing and Coding: Colonoscopy and Sigmoidoscopy-Diagnostic
Policy ID: ART-56394

CPT Codes Commonly Billed with B20

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

207 linkages
  • 92235 CMS LCD: Billing and Coding: Ophthalmic Angiography (Fluorescein and Indocyanine Green) CMS LCD
  • 92240 CMS LCD: Billing and Coding: Ophthalmic Angiography (Fluorescein and Indocyanine Green) CMS LCD
  • 0031U CMS LCD: Billing and Coding: Pharmacogenomics Testing CMS LCD
  • 0173U CMS LCD: Billing and Coding: Pharmacogenomics Testing CMS LCD
  • 0423U CMS LCD: Billing and Coding: Pharmacogenomics Testing CMS LCD
  • 81407 CMS LCD: Billing and Coding: Pharmacogenomics Testing CMS LCD
  • 0349U CMS LCD: Billing and Coding: Pharmacogenomics Testing CMS LCD
  • 81408 CMS LCD: Billing and Coding: Pharmacogenomics Testing CMS LCD
  • 0175U CMS LCD: Billing and Coding: Pharmacogenomics Testing CMS LCD
  • 0032U CMS LCD: Billing and Coding: Pharmacogenomics Testing CMS LCD

Convert B20 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
B20 042 00000

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

ICD-10 B20, Billing FAQ

Is ICD-10 code B20 billable? +

Yes, B20 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What codes are Type 1 Excludes for B20? +

Type 1 Excludes (never code together with B20): asymptomatic human immunodeficiency virus [HIV] infection status (Z21); exposure to HIV virus (Z20.6); inconclusive serologic evidence of HIV (R75)

Does B20 affect Medicare Advantage HCC risk adjustment? +

Yes. B20 maps to CMS-HCC v28 category 1. Capture this diagnosis annually for accurate Medicare Advantage risk score.

Is B20 a CC or MCC for inpatient DRG? +

Yes, this code is designated as CC. Documenting as a secondary diagnosis on inpatient claims can shift the DRG to a higher-weighted category.

What CPT codes are commonly billed with B20? +

Procedures frequently paired with B20 include: 92235, 92240, 0031U, 0173U, 0423U.

What ICD-9 codes does B20 map to? +

Per CMS GEMs, B20 maps to ICD-9 codes: 042. 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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