-Does “HIV-related illness” mean opportunistic infection?
-What MUST the provider document in order to assign B20 instead of Z21?
2019 ICD-10-CM DGs state: Previously diagnosed HIV-related illness
Patients with any known prior diagnosis of an HIV-related illness should be coded to B20.
Once a patient has developed an HIV-related illness, the patient should always be assigned B20 on every subsequent admission/encounter.
Patients previously diagnosed with any HIV illness (B20) should never be assigned to R75 or Z21, asymptomatic HIV infection status.
Question: Is my understanding of this guideline correct…
B20: In order to assign B20 (symptomatic HIV/AIDS/ARC), the patient must have HAD a previous HIV-related illness (a.k.a opportunistic infection). The provider MUST document either AIDS or HIV with history of related illness (opportunistic infection).
Z21: If the patient has NOT had an HIV-related illness (a.k.a opportunistic infection) the patient should be assigned Z21, asymptomatic HIV infection status.
Link to CDCs list of the most common OIs (opportunistic infections) for people living in the United States
I appreciate your guidance!