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

ICD-10 B97.33

Billable / Specific CC

Human T-cell lymphotrophic virus, type I [HTLV-I] as the cause of diseases classified elsewhere

B97
Block
0
Synonyms
41
LCDs
4
Payer Policies
15
Linked CPTs

About ICD-10-CM B97.33

ICD-10-CM code B97.33 represents Human T-cell lymphotrophic virus, type I [HTLV-I] as the cause of diseases classified elsewhere. This is a billable/specific code in the Infectious and Parasitic Diseases chapter (block B97). The 2026 edition of ICD-10-CM B97.33 became effective on October 1, 2025.

Coding Tips for B97.33

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

Inpatient DRG impact: CC

B97.33 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.

Inpatient DRG Impact, CC

codes Human T-cell lymphotrophic virus, type I [HTLV-I] as the cause of diseases classified elsewhere. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.

Medicare LCD Coverage for B97.33

Local Coverage Determinations (LCDs) from CMS MACs that list B97.33 as a covered diagnosis.

41 LCDs

Showing top 10 of 41 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Lab: Flow Cytometry
Article ID: 57689, Effective: 2025-11-06 00:00:00, 1518 covered, 0 non-covered
CPT 88189 →
CMS LCD: Billing and Coding: Lab: Flow Cytometry
Article ID: 57689, Effective: 2025-11-06 00:00:00, 1518 covered, 0 non-covered
CPT 86360 →
CMS LCD: Billing and Coding: Lab: Flow Cytometry
Article ID: 57689, Effective: 2025-11-06 00:00:00, 1518 covered, 0 non-covered
CPT 86361 →
CMS LCD: Billing and Coding: Lab: Flow Cytometry
Article ID: 57689, Effective: 2025-11-06 00:00:00, 1518 covered, 0 non-covered
CPT 88187 →
CMS LCD: Billing and Coding: Lab: Flow Cytometry
Article ID: 57689, Effective: 2025-11-06 00:00:00, 1518 covered, 0 non-covered
CPT 86363 →
CMS LCD: Billing and Coding: Lab: Flow Cytometry
Article ID: 57689, Effective: 2025-11-06 00:00:00, 1518 covered, 0 non-covered
CPT 86359 →
CMS LCD: Billing and Coding: Lab: Flow Cytometry
Article ID: 57689, Effective: 2025-11-06 00:00:00, 1518 covered, 0 non-covered
CPT 86356 →
CMS LCD: Billing and Coding: Lab: Flow Cytometry
Article ID: 57689, Effective: 2025-11-06 00:00:00, 1518 covered, 0 non-covered
CPT 88188 →
CMS LCD: Billing and Coding: Lab: Flow Cytometry
Article ID: 57689, Effective: 2025-11-06 00:00:00, 1518 covered, 0 non-covered
CPT 88184 →
CMS LCD: Billing and Coding: Lab: Flow Cytometry
Article ID: 57689, Effective: 2025-11-06 00:00:00, 1518 covered, 0 non-covered
CPT 88185 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing B97.33.

4 policies

1 Cigna

Flow Cytometry - (0538)
Policy ID: MM_0538

3 Medicare

Billing and Coding: Lab: Flow Cytometry
Policy ID: ART-55717
Billing and Coding: Flow Cytometry
Policy ID: ART-56464
Billing and Coding: Lab: Flow Cytometry
Policy ID: ART-57689

CPT Codes Commonly Billed with B97.33

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

15 linkages
  • 86356 CMS LCD: Billing and Coding: Lab: Flow Cytometry CMS LCD
  • 86357 CMS LCD: Billing and Coding: Lab: Flow Cytometry CMS LCD
  • 86361 CMS LCD: Billing and Coding: Lab: Flow Cytometry CMS LCD
  • 88189 CMS LCD: Billing and Coding: Lab: Flow Cytometry CMS LCD
  • 88182 CMS LCD: Billing and Coding: Lab: Flow Cytometry CMS LCD
  • 86367 CMS LCD: Billing and Coding: Lab: Flow Cytometry CMS LCD
  • 88184 CMS LCD: Billing and Coding: Lab: Flow Cytometry CMS LCD
  • 88188 CMS LCD: Billing and Coding: Lab: Flow Cytometry CMS LCD
  • 86360 CMS LCD: Billing and Coding: Lab: Flow Cytometry CMS LCD
  • 88187 CMS LCD: Billing and Coding: Lab: Flow Cytometry CMS LCD

Convert B97.33 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
B97.33 07951 00000

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

Codes Adjacent To B97.33

Other codes in section B95-B97 (Bacterial and viral infectious agents).

B95 Streptococcus, Staphylococcus, and Enterococcus as the cause of diseases classified elsewhere (non-billable) B95.0 Streptococcus, group A, as the cause of diseases classified elsewhere B95.1 Streptococcus, group B, as the cause of diseases classified elsewhere B95.2 Enterococcus as the cause of diseases classified elsewhere B95.3 Streptococcus pneumoniae as the cause of diseases classified elsewhere B95.4 Other streptococcus as the cause of diseases classified elsewhere B95.5 Unspecified streptococcus as the cause of diseases classified elsewhere B95.6 Staphylococcus aureus as the cause of diseases classified elsewhere (non-billable) B95.61 Methicillin susceptible Staphylococcus aureus infection as the cause of diseases classified elsewhere B95.62 Methicillin resistant Staphylococcus aureus infection as the cause of diseases classified elsewhere B95.7 Other staphylococcus as the cause of diseases classified elsewhere B95.8 Unspecified staphylococcus as the cause of diseases classified elsewhere B96 Other bacterial agents as the cause of diseases classified elsewhere (non-billable) B96.0 Mycoplasma pneumoniae [M. pneumoniae] as the cause of diseases classified elsewhere B96.1 Klebsiella pneumoniae [K. pneumoniae] as the cause of diseases classified elsewhere B96.2 Escherichia coli [E. coli ] as the cause of diseases classified elsewhere (non-billable) B96.20 Unspecified Escherichia coli [E. coli] as the cause of diseases classified elsewhere B96.21 Shiga toxin-producing Escherichia coli [E. coli] [STEC] O157 as the cause of diseases classified elsewhere B96.22 Other specified Shiga toxin-producing Escherichia coli [E. coli] [STEC] as the cause of diseases classified elsewhere B96.23 Unspecified Shiga toxin-producing Escherichia coli [E. coli] [STEC] as the cause of diseases classified elsewhere

ICD-10 B97.33, Billing FAQ

Is ICD-10 code B97.33 billable? +

Yes, B97.33 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

Is B97.33 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 B97.33? +

Procedures frequently paired with B97.33 include: 86356, 86357, 86361, 88189, 88182.

What ICD-9 codes does B97.33 map to? +

Per CMS GEMs, B97.33 maps to ICD-9 codes: 07951. 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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