2027 ICD-10-CM Diagnosis Code B19.20Unspecified viral hepatitis C without hepatic coma

ICD-10-CM Codes›A00–B99›B15-B19›B19

ICD-10-CM B19.20
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

B19.20 is a billable ICD-10-CM diagnosis code for unspecified viral hepatitis C without hepatic coma. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 441 through 443. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Hepatitis and Viral infection.

B19.20 does not risk-adjust for Medicare Advantage under the CMS-HCC V28 model. It still risk-adjusts in the RxHCC Part D (V08) category 55 for payment year 2027.

Code Identity

ICD-10-CM Code
B19.20
Billable Status
Yes — Valid for Submission
Code Describes
Unspecified viral hepatitis C without hepatic coma
Short Description
Unspecified viral hepatitis C without hepatic coma
Same as the full description in the CMS dataset.
Parent Code
B19.2
Unspecified viral hepatitis C

Code Classification

ChapterA00–B99Certain infectious and parasitic diseases
SectionB15-B19Viral hepatitis
CategoryB19Unspecified viral hepatitis
This CodeB19.20Unspecified viral hepatitis C without hepatic coma

Medicare Risk Adjustment (HCC)Billing

B19.20 does not risk-adjust for Medicare Advantage under the CMS-HCC V28 model, but it maps to payment categories in the other CMS models shown below.

CMS-HCC V28 (Medicare Advantage Payment Model)
Not mapped
no payment category in the model that pays 100% of MA risk scores
Prior Model (CMS-HCC V24)
Not mapped under V24
this diagnosis newly risk-adjusts under the V28 model
Part D (RxHCC)
RxHCC 55 — Acute or Unspecified Viral Hepatitis C
also risk-adjusts in the Part D prescription drug model (V08)

Source: CMS Payment Year 2027 risk adjustment mappings and model software. Weights are relative factors, not dollar amounts; a beneficiary's total RAF also includes demographics and interactions. Browse all CMS-HCC categories.

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Complication of transplanted liver
  • Glomerular disease due to infectious disease
  • Glomerulonephritis due to hepatitis C
  • Hepatitis B and hepatitis C
  • Liver disorder in pregnancy
  • Reactivation of hepatitis C viral hepatitis
  • Recurrent hepatitis
  • Recurrent hepatitis C virus induced liver disease following liver transplant
  • Viral hepatitis C
  • Viral hepatitis C in mother during pregnancy
  • Viral hepatitis complicating pregnancy, childbirth and the puerperium

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to B19.20: its own notes plus those printed at block B15-B19 and Chapter 1. A note printed at a category, block or chapter applies to every code under it.

Includes

Further defines, or gives examples of, the content of the category.

From Chapter 1 (A00-B99) Certain infectious and parasitic diseases applies to 1,068 codes
  • diseases generally recognized as communicable or transmissible

Applicable To

Conditions this code is used for: synonyms of the title or, for "other specified" codes, the conditions assigned to it. The list is not exhaustive.

  • Viral hepatitis C NOS

Excludes1

Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.

From Block B15-B19 Viral hepatitis applies to 23 codes
  • sequelae of viral hepatitis (B94.2)

Excludes2

Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.

From Block B15-B19 Viral hepatitis applies to 23 codes
  • cytomegaloviral hepatitis (B25.1)
  • herpesviral [herpes simplex] hepatitis (B00.81)
From Chapter 1 (A00-B99) Certain infectious and parasitic diseases applies to 1,068 codes
  • carrier or suspected carrier of infectious disease (Z22.-)
  • certain localized infections - see body system-related chapters
  • infectious and parasitic diseases complicating pregnancy, childbirth and the puerperium (O98.-)
  • infectious and parasitic diseases specific to the perinatal period (P35-P39)
  • influenza and other acute respiratory infections (J00-J22)

Use Additional Code

Add a second code, after this one, to fully describe the condition.

From Chapter 1 (A00-B99) Certain infectious and parasitic diseases applies to 1,068 codes
  • code to identify resistance to antimicrobial drugs (Z16.-)

Source: CMS ICD-10-CM Tabular List. How to read instructional notes.

Referenced in Other NotesGuidance

Instructional notes printed at other codes that name B19.20, its category, or a range that includes it.

Applicable To 1

These notes mention B19.20.

  • O98.4 Viral hepatitis complicating pregnancy, childbirth and the puerperium
    Conditions in B15-B19 names B15-B19, which includes this code

Excludes1 4

These codes carry an Excludes1 note naming B19.20: they are not reported together with it, unless the two conditions are unrelated.

  • K73 Chronic hepatitis, not elsewhere classified
    viral hepatitis (chronic) (B15-B19) names B15-B19, which includes this code
  • K75.2 Nonspecific reactive hepatitis
    viral hepatitis (B15-B19) names B15-B19, which includes this code
  • K75.3 Granulomatous hepatitis, not elsewhere classified
    viral hepatitis (B15-B19) names B15-B19, which includes this code
  • K75.9 Inflammatory liver disease, unspecified
    viral hepatitis (B15-B19) names B15-B19, which includes this code

Excludes2 3

These codes carry an Excludes2 note naming B19.20: its condition is not part of those codes, and both may be reported when the patient has both.

  • Block K70-K77 Diseases of liver
    viral hepatitis (B15-B19) names B15-B19, which includes this code
  • K72 Hepatic failure, not elsewhere classified
    viral hepatitis with hepatic coma (B15-B19) names B15-B19, which includes this code
  • T80.6 Other serum reactions
    serum hepatitis (B16-B19) names B16-B19, which includes this code

Code First 1

These codes say to code first a condition named in the note, and B19.20 is one of the conditions named.

  • M02 Postinfective and reactive arthropathies
    viral hepatitis (B15-B19) names B15-B19, which includes this code

Code Also 2

These codes say B19.20 may also be needed to fully describe the condition. The note gives no sequencing direction.

  • K76.82 Hepatic encephalopathy
    viral hepatitis without hepatic coma (B15.9, B16.1, B16.9, B17.10, B19.10, B19.20, B19.9)
  • K74 Fibrosis and cirrhosis of liver
    if applicable, viral hepatitis (acute) (chronic) (B15-B19) names B15-B19, which includes this code

Index to Diseases and InjuriesGuidance

Alphabetical index entries that point to this code.

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR INF007
Hepatitis
Default principal diagnosis: inpatient Yes · outpatient Yes
CCSR INF008
Viral infection
Default principal diagnosis: inpatient No · outpatient No

Patient EducationClinical

Hepatitis C

Hepatitis is inflammation of the liver. Inflammation is swelling that happens when tissues of the body are injured or infected. Inflammation can damage organs.

The full article covers:

  • What is hepatitis C?
  • How is hepatitis C spread?
  • Who is more likely to get hepatitis C?
  • What are the symptoms of hepatitis C?
  • What other problems can hepatitis C cause?
  • How is hepatitis C diagnosed?
  • What are the treatments for hepatitis C?
  • Can hepatitis C be prevented?

Read the full article at MedlinePlus

Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.

Convert B19.20 to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
070.70 Hpt C w/o hepat coma NOS
Exact Match The mapping is direct, with no qualifiers.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2026No changes
FY 2027CurrentCurrent code set, no changesEffective October 1, 2026 through September 30, 2027.

Questions About B19.20Overview

What is the ICD-10 code for unspecified viral hepatitis C without hepatic coma?

The ICD-10-CM code for unspecified viral hepatitis C without hepatic coma is B19.20 (sometimes written as B1920). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

Is B19.20 (Unspecified viral hepatitis C) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report unspecified viral hepatitis C without hepatic coma on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What MS-DRG does B19.20 group to?

When unspecified viral hepatitis C without hepatic coma is the principal diagnosis on an inpatient stay, it groups to MS-DRG 442, 441, 443, with relative weights from 0.6890 to 1.8226 depending on complications. Higher weights mean higher Medicare reimbursement.

Can B19.20 be reported with B94.2?

Not as a rule. The Excludes1 note at block B15-B19, which applies to B19.20, lists "sequelae of viral hepatitis (B94.2)". An Excludes1 note means the excluded code is never reported together with this one; the only exception is when the two conditions are unrelated to each other (Official Guidelines, Section I.A.12.a).

What is the ICD-9 equivalent of B19.20?

Under the General Equivalence Mappings, unspecified viral hepatitis C without hepatic coma converts to ICD-9-CM 070.70 (hpt C w/o hepat coma NOS). The mapping is a direct match.

Does B19.20 risk-adjust for Medicare Advantage payment?

Not for Medicare Advantage: B19.20 maps to no category in the CMS-HCC V28 model. It still risk-adjusts in the RxHCC Part D (V08) category 55 (Acute or Unspecified Viral Hepatitis C).