2027 ICD-10-CM Diagnosis Code B20Human immunodeficiency virus [HIV] disease

ICD-10-CM Codes›A00–B99›B20›B20

ICD-10-CM B20
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

B20 is a billable ICD-10-CM diagnosis code for human immunodeficiency virus [HIV] disease. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 969 through 970, 974 through 977. As a secondary diagnosis, it counts as a complication or comorbidity (CC) and moves an inpatient stay to a higher severity level within its MS-DRG family. It does not count, however, when the principal diagnosis is one of 5 closely related codes. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under HIV infection.

For Medicare Advantage risk adjustment, B20 maps to CMS-HCC Category 1 (HIV/AIDS) under the V28 model, adding a risk factor of about 0.301 for a community, non-dual, aged beneficiary in payment year 2027.

Code Identity

ICD-10-CM Code
B20
Billable Status
Yes — Valid for Submission
Code Describes
Human immunodeficiency virus [HIV] disease
Short Description
Human immunodeficiency virus [HIV] disease
Same as the full description in the CMS dataset.
Chapter
B20
Human immunodeficiency virus [HIV] disease

Code Classification

ChapterA00–B99Certain infectious and parasitic diseases
SectionB20Human immunodeficiency virus [HIV] disease
CategoryB20Human immunodeficiency virus [HIV] disease
This CodeB20Human immunodeficiency virus [HIV] disease

Medicare Risk Adjustment (HCC)Billing

B20 maps to a payment category in the CMS-HCC model used to risk-adjust Medicare Advantage payments. Weights are the published community factors for payment year 2027.

CMS-HCC V28 Category (Payment Model)
HCC 1— HIV/AIDS
Payment HCC · PY 2027 one of 3 ICD-10-CM codes in this category
Risk Adjustment Factor (RAF) Weight
+0.301
community, non-dual, aged · ranges 0.109–1.322 across segments
Hierarchy
Top of its hierarchy
HCC 1 is not superseded by any other condition category
Prior Model (CMS-HCC V24)
HCC 1
V24 retired V28 pays 100% of MA risk scores since PY 2026
Other CMS Models
PACE (CMS-HCC V22): HCC 1 · ESRD (V21): HCC 1 · ESRD (V24): HCC 1
ESRD V21 weights: 0.154 dialysis, 0.350–1.708 functioning graft · ESRD V24 weights: 0.122 dialysis, 0.292–1.302 functioning graft
Part D (RxHCC)
RxHCC 1 — HIV/AIDS
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.

  • Abnormal weight loss
  • Abnormal weight loss associated with AIDS
  • Acquired hemolytic anemia associated with AIDS
  • Acquired hemolytic anemia co-occurrent with human immunodeficiency virus infection
  • Acquired immune deficiency syndrome complicating childbirth
  • Acquired immune deficiency syndrome-related nephropathy
  • Acquired immunodeficiency syndrome-associated disorder
  • Acute endocarditis
  • Acute endocarditis co-occurrent with human immunodeficiency virus infection
  • Acute endocarditis with AIDS
  • Acute HIV infection
  • Adenoviral encephalitis
  • Adenoviral nervous system infection
  • Agranulocytosis
  • Agranulocytosis co-occurrent with human immunodeficiency virus infection
  • Agranulocytosis with AIDS
  • AIDS
  • AIDS wasting syndrome
  • Anemia associated with AIDS
  • Anemia co-occurrent with human immunodeficiency virus infection
  • Aplastic anemia co-occurrent with human immunodeficiency virus infection
  • Aplastic anemia with AIDS
  • Aseptic meningitis due to human immunodeficiency virus infection
  • Aspergillosis co-occurrent with human immunodeficiency virus infection
  • Associated pulmonary arterial hypertension
  • Asymptomatic human immunodeficiency virus infection
  • Autonomic disorder due to HIV infection
  • Bacterial infection due to human immunodeficiency virus infection
  • Bacterial pneumonia co-occurrent with human immunodeficiency virus infection
  • Bacterial pneumonia with AIDS
  • Blindness with AIDS
  • Burkitt lymphoma co-occurrent with human immunodeficiency virus infection
  • Cachexia
  • Cachexia associated with AIDS
  • Candidiasis of esophagus
  • Candidiasis of esophagus co-occurrent with human immunodeficiency virus infection
  • Candidiasis of lung
  • Candidiasis of lung with AIDS
  • Candidiasis of mouth co-occurrent with human immunodeficiency virus infection
  • Candidiasis of mouth with AIDS
  • Candidiasis of upper respiratory tract co-occurrent with human immunodeficiency virus infection
  • Carcinoma of cervix
  • Carcinoma of uterine cervix, invasive
  • Cardiomyopathy co-occurrent with human immunodeficiency virus infection
  • Central nervous disorder with AIDS
  • Central nervous system demyelinating disease with AIDS
  • Cholangitis with AIDS
  • Chronic hepatitis C co-occurrent with human immunodeficiency virus infection
  • Chronic herpes simplex
  • Chronic infection caused by herpes simplex virus co-occurrent with human immunodeficiency virus infection
  • Coccidioidomycosis with AIDS
  • Coccidiosis co-occurrent with human immunodeficiency virus infection
  • Congenital acquired immune deficiency syndrome
  • Congenital human immunodeficiency virus infection
  • Congenital human immunodeficiency virus positive status syndrome
  • Cryptococcosis with AIDS
  • Dementia co-occurrent with human immunodeficiency virus infection
  • Dementia with AIDS
  • Demyelinating disease of central nervous system co-occurrent with human immunodeficiency virus infection
  • Dermatomycosis with AIDS
  • Dermatophytosis co-occurrent with human immunodeficiency virus infection
  • Diffuse high grade B-cell lymphoma
  • Diffuse large B-cell lymphoma
  • Diffuse non-Hodgkin immunoblastic lymphoma co-occurrent with human immunodeficiency virus infection
  • Diffuse non-Hodgkin's lymphoma, immunoblastic
  • Disease caused by Eimeriidae
  • Disease caused by JC polyomavirus
  • Disorder of autonomic nervous system due to infectious disease
  • Disorder of central nervous system co-occurrent with human immunodeficiency virus infection
  • Disorder of eye proper co-occurrent with human immunodeficiency virus infection
  • Disorder of gastrointestinal tract co-occurrent with human immunodeficiency virus infection
  • Disorder of immune reconstitution
  • Disorder of kidney co-occurrent with human immunodeficiency virus infection
  • Disorder of peripheral nervous system co-occurrent with human immunodeficiency virus infection
  • Disorder of respiratory system co-occurrent with human immunodeficiency virus infection
  • Disorder of skin co-occurrent with human immunodeficiency virus infection
  • Disorder of skin due to human immunodeficiency virus infection
  • Disorder of spinal cord co-occurrent with human immunodeficiency virus infection
  • Disseminated atypical infection caused by Mycobacterium co-occurrent with human immunodeficiency virus infection
  • Disseminated atypical mycobacterial infection
  • Disseminated candidiasis
  • Disseminated candidiasis with AIDS
  • Disseminated infection caused by Strongyloides co-occurrent with human immunodeficiency virus infection
  • Disseminated strongyloidiasis
  • Distribution of body fat loss - finding
  • Dyspnea with AIDS
  • Encephalitis caused by human immunodeficiency virus type 1
  • Encephalitis with AIDS
  • Encephalomyelitis with AIDS
  • Encephalopathy with AIDS
  • Enlargement of liver co-occurrent with human immunodeficiency virus infection
  • Enteritis of intestine due to human immunodeficiency virus disease
  • Enteritis of small intestine due to human immunodeficiency virus disease
  • Eosinophilic folliculitis due to human immunodeficiency virus infection
  • Eosinophilic pustular folliculitis
  • Eruption of skin co-occurrent with human immunodeficiency virus infection
  • Esophagitis due to human immunodeficiency virus disease
  • Exacerbation of psoriasis
  • Extrapulmonary tuberculosis co-occurrent with human immunodeficiency virus infection
  • Failure to thrive
  • Failure to thrive in infant
  • Failure to thrive in infant with AIDS
  • Fatigue with AIDS
  • Focal segmental glomerulosclerosis
  • Focal segmental glomerulosclerosis co-occurrent with human immunodeficiency virus infection
  • Focal segmental glomerulosclerosis with infectious disease
  • Gastrointestinal malabsorption syndrome co-occurrent with human immunodeficiency virus infection
  • Generalized enlarged lymph nodes
  • Hairy leukoplakia of tongue
  • Hairy leukoplakia of tongue associated with HIV disease
  • Heart disease co-occurrent with human immunodeficiency virus infection
  • Hematopoietic system disease with AIDS
  • Hemophagocytic lymphohistiocytosis
  • Hemophagocytic syndrome with human immunodeficiency virus infection
  • Hepatitis B associated with Human immunodeficiency virus infection
  • Hepatomegaly with AIDS
  • Herpes zoster dermatitis
  • Herpes zoster with AIDS
  • Histoplasmosis with AIDS
  • HIV CDC stage finding
  • HIV infection with acute lymphadenitis
  • HIV infection with infectious mononucleosis-like syndrome
  • HIV-related sclerosing cholangitis
  • Human immunodeficiency virus Centers for Disease Control and Prevention dual infection with HIV-1 and HIV-2
  • Human immunodeficiency virus Centers for Disease Control and Prevention stage 1
  • Human immunodeficiency virus Centers for Disease Control and Prevention stage 2
  • Human immunodeficiency virus Centers for Disease Control and Prevention stage 3
  • Human immunodeficiency virus Centers for Disease Control and Prevention stage unknown
  • Human immunodeficiency virus Centers for Disease Control and Prevention undifferentiated type
  • Human immunodeficiency virus complicating pregnancy childbirth and the puerperium
  • Human immunodeficiency virus encephalitis
  • Human immunodeficiency virus encephalopathy
  • Human immunodeficiency virus enteropathy
  • Human immunodeficiency virus I infection
  • Human immunodeficiency virus in mother complicating childbirth
  • Human immunodeficiency virus infection
  • Human immunodeficiency virus infection constitutional disease
  • Human immunodeficiency virus infection with cognitive impairment
  • Human immunodeficiency virus infection with neurological disease
  • Human immunodeficiency virus infection with secondary clinical infectious disease
  • Human immunodeficiency virus leukoencephalopathy
  • Human immunodeficiency virus modified skin disease
  • Human immunodeficiency virus myopathy
  • Human immunodeficiency virus World Health Organization 2007 stage 1 co-occurrent with malaria
  • Human immunodeficiency virus World Health Organization 2007 stage 1 co-occurrent with tuberculosis
  • Human immunodeficiency virus World Health Organization 2007 stage 2 co-occurrent with malaria
  • Human immunodeficiency virus World Health Organization 2007 stage 2 co-occurrent with tuberculosis
  • Human immunodeficiency virus World Health Organization 2007 stage 3 co-occurrent with malaria
  • Human immunodeficiency virus World Health Organization 2007 stage 3 co-occurrent with tuberculosis
  • Human immunodeficiency virus World Health Organization 2007 stage 4 co-occurrent with malaria
  • Human immunodeficiency virus World Health Organization 2007 stage 4 co-occurrent with tuberculosis
  • Hyperhidrosis with AIDS
  • Immune reconstitution finding
  • Immune reconstitution inflammatory syndrome
  • Immune reconstitution inflammatory syndrome caused by human immunodeficiency virus infection
  • Immune reconstitution inflammatory syndrome with Kaposi's sarcoma
  • Immune reconstitution reaction
  • Infection by Pneumocystis jirovecii
  • Infection caused by Coccidia co-occurrent with acquired immunodeficiency syndrome
  • Infection caused by Cryptosporidium co-occurrent with human immunodeficiency virus infection
  • Infection caused by Cytomegalovirus co-occurrent with human immunodeficiency virus infection
  • Infection caused by herpes simplex virus co-occurrent with human immunodeficiency virus infection
  • Infection caused by herpes zoster virus co-occurrent with human immunodeficiency virus infection
  • Infection caused by Isospora co-occurrent with acquired immunodeficiency syndrome
  • Infection caused by Nocardia co-occurrent with human immunodeficiency virus infection
  • Infection caused by Pneumocystis jirovecii with acquired immunodeficiency syndrome
  • Infection caused by Pneumocystis jirovecii with infection caused by human immunodeficiency virus
  • Infection caused by Salmonella co-occurrent with human immunodeficiency virus infection
  • Infection caused by Strongyloides co-occurrent with human immunodeficiency virus infection
  • Infection caused by Toxoplasma gondii co-occurrent with acquired immunodeficiency syndrome
  • Infection causing parkinsonism
  • Infectious disease with acquired immune deficiency syndrome
  • Infectious gastroenteritis co-occurrent with human immunodeficiency virus infection
  • Infectious gastroenteritis with AIDS
  • Infectious mononucleosis caused by human immunodeficiency virus
  • Infectious mononucleosis caused by human immunodeficiency virus type I
  • Infective arthritis co-occurrent with human immunodeficiency virus infection
  • Infective arthritis with AIDS
  • Intestinal malabsorption with AIDS
  • Invasive carcinoma of uterine cervix co-occurrent with human immunodeficiency virus infection
  • Isosporiasis
  • Isosporiasis co-occurrent with human immunodeficiency virus infection
  • Kaposi's sarcoma with AIDS
  • Leukoplakia of tongue
  • Leukoplakia of tongue associated with HIV disease
  • Low vision with AIDS
  • Lymphadenopathy co-occurrent with human immunodeficiency virus infection
  • Malaise
  • Malaise with AIDS
  • Malignant neoplasm with AIDS
  • Malignant neoplastic disease co-occurrent with human immunodeficiency virus infection
  • Microsporidiosis associated with acquired immunodeficiency syndrome
  • Microsporidiosis co-occurrent with human immunodeficiency virus infection
  • Motor neuron disease due to human immunodeficiency virus infection
  • Multidermatomal herpes zoster infection
  • Multidermatomal infection caused by Herpes zoster co-occurrent with human immunodeficiency virus infection
  • Mycobacteriosis with AIDS
  • Mycosis due to human immunodeficiency virus infection
  • Myelitis co-occurrent with human immunodeficiency virus infection
  • Myelitis with AIDS
  • Myelopathy with AIDS
  • Myocarditis co-occurrent with human immunodeficiency virus infection
  • Myocarditis with AIDS
  • Nephrotic syndrome co-occurrent with human immunodeficiency virus infection
  • Neuralgia co-occurrent with human immunodeficiency virus infection
  • Neuralgia with AIDS
  • Neuritis co-occurrent with human immunodeficiency virus infection
  • Neuritis with AIDS
  • Neuropathy caused by human immunodeficiency virus
  • Neutropenia associated with infectious disease
  • Neutropenia with AIDS
  • Nocardiosis with AIDS
  • Non-Hodgkin lymphoma associated with Human immunodeficiency virus infection
  • Noninfectious gastroenteritis with AIDS
  • Nutritional deficiency with AIDS
  • Opportunistic infectious disease
  • Opportunistic mycosis
  • Opportunistic mycosis co-occurrent with human immunodeficiency virus infection
  • Oral hairy leukoplakia
  • Oral hairy leukoplakia associated with HIV disease
  • Organic brain syndrome co-occurrent with human immunodeficiency virus infection
  • Organic brain syndrome with AIDS
  • Organic dementia with AIDS
  • Papular pruritic eruption of skin due to human immunodeficiency virus infection
  • Parasitic disease due to human immunodeficiency virus infection
  • Parkinsonism due to human immunodeficiency virus infection
  • Pediatric failure to thrive
  • Pediatric human immunodeficiency virus infection
  • Perinatal infection of fetus and/or neonate caused by human immunodeficiency virus
  • Periodontitis exacerbated by human immunodeficiency virus infection
  • Persistent generalized lymphadenopathy
  • Persistent generalized lymphadenopathy caused by human immunodeficiency virus
  • Pityriasis rubra pilaris
  • Pityriasis rubra pilaris due to human immunodeficiency virus infection
  • Pneumococcal pneumonia
  • Pneumococcal pneumonia with AIDS
  • Pneumonia with AIDS
  • Polyneuropathy co-occurrent with human immunodeficiency virus infection
  • Polyneuropathy with AIDS
  • Presenile dementia co-occurrent with human immunodeficiency virus infection
  • Presenile dementia with AIDS
  • Primary cerebral lymphoma
  • Primary cerebral lymphoma co-occurrent with human immunodeficiency virus infection
  • Primary effusion lymphoma
  • Primary effusion lymphoma due to human immune deficiency virus infection
  • Primary human immunodeficiency virus infection
  • Primary lymphoma of brain with AIDS
  • Progressive multifocal leukoencephalopathy
  • Progressive multifocal leukoencephalopathy co-occurrent with human immunodeficiency virus infection
  • Progressive multifocal leukoencephalopathy with AIDS
  • Pruritus due to human immunodeficiency virus infection
  • Psoriasis exacerbated by human immunodeficiency virus infection
  • Pulmonary arterial hypertension associated with HIV infection
  • Pyrexia of unknown origin
  • Pyrexia of unknown origin co-occurrent with human immunodeficiency virus infection
  • Radiculitis co-occurrent with human immunodeficiency virus infection
  • Radiculitis with AIDS
  • Recurrent bacterial pneumonia
  • Recurrent bacterial pneumonia co-occurrent with human immunodeficiency virus infection
  • Recurrent lower respiratory tract infection
  • Recurrent pneumonia
  • Recurrent salmonella sepsis co-occurrent with human immunodeficiency virus infection
  • Renal failure syndrome co-occurrent with human immunodeficiency virus infection
  • Respiratory disorder with AIDS
  • Reticulosarcoma co-occurrent with human immunodeficiency virus infection
  • Reticulosarcoma with AIDS
  • Retinal vascular changes with AIDS
  • Retinopathy with AIDS
  • Retroviridae encephalitis
  • Salivary gland disease with AIDS
  • Salmonella infection with AIDS
  • Sclerosing cholangitis
  • Seborrheic dermatitis due to human immunodeficiency virus infection
  • Secondary infection
  • Sepsis caused by coliform bacteria
  • Sepsis caused by Salmonella
  • Sepsis with acquired immunodeficiency syndrome
  • Skin disorder with AIDS
  • Skin rash with AIDS
  • Splenomegaly co-occurrent with human immunodeficiency virus infection
  • Strongyloidiasis with AIDS
  • Subacute adenoviral encephalitis
  • Subacute adenoviral encephalitis co-occurrent with human immunodeficiency virus infection
  • Subacute adenoviral encephalitis with AIDS
  • Subacute endocarditis
  • Subacute endocarditis with AIDS
  • Subacute myocarditis with AIDS
  • Symptomatic human immunodeficiency virus I infection
  • Symptomatic human immunodeficiency virus infection
  • Thrombocytopenia with AIDS
  • Tuberculosis with AIDS
  • Tuberculosis, extrapulmonary
  • Vacuolar myelopathy
  • Viral disease in mother complicating childbirth
  • Viral kidney infection
  • Viral pneumonia with AIDS
  • Visual impairment co-occurrent with human immunodeficiency virus infection
  • Weight decreased
  • White matter disorder caused by infection
  • World Health Organization 2007 Human immunodeficiency virus infection clinical stage 1
  • World Health Organization 2007 Human immunodeficiency virus infection clinical stage 2
  • World Health Organization 2007 Human immunodeficiency virus infection clinical stage 3
  • World Health Organization 2007 Human immunodeficiency virus infection clinical stage 4

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to B20: its own notes plus those printed at 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.

On B20 itself
  • acquired immune deficiency syndrome [AIDS]
  • AIDS-related complex [ARC]
  • HIV infection, symptomatic
From Chapter 1 (A00-B99) Certain infectious and parasitic diseases applies to 1,068 codes
  • diseases generally recognized as communicable or transmissible

Excludes1

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

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

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 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)

Code First

The underlying condition named in the note is sequenced before this code.

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

Use Additional Code

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

On B20 itself
  • code(s) to identify all manifestations of HIV infection
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 B20, its category, or a range that includes it.

Applicable To 1

These notes mention B20.

  • Z83.0 Family history of human immunodeficiency virus [HIV] disease
    Conditions classifiable to B20

Excludes1 10

These codes carry an Excludes1 note naming B20: they are not reported together with it, unless the two conditions are unrelated.

  • B97.3 Retrovirus as the cause of diseases classified elsewhere
    Human immunodeficiency virus [HIV] disease (B20)
  • D61.81 Pancytopenia
    pancytopenia (due to) (with) human immunodeficiency virus disease (B20.-)
  • D84.81 Immunodeficiency due to conditions classified elsewhere
    human immunodeficiency virus [HIV] disease (B20)
  • D89.89 Other specified disorders involving the immune mechanism, not elsewhere classified
    human immunodeficiency virus disease (B20)
  • I88 Nonspecific lymphadenitis
    human immunodeficiency virus [HIV] disease resulting in generalized lymphadenopathy (B20)
  • L04 Acute lymphadenitis
    human immunodeficiency virus [HIV] disease resulting in generalized lymphadenopathy (B20)
  • R62.5 Other and unspecified lack of expected normal physiological development in childhood
    HIV disease resulting in failure to thrive (B20)
  • R75 Inconclusive laboratory evidence of human immunodeficiency virus [HIV]
    human immunodeficiency virus [HIV] disease (B20)
  • Z21 Asymptomatic human immunodeficiency virus [HIV] infection status
    acquired immunodeficiency syndrome (B20)
  • Z21 Asymptomatic human immunodeficiency virus [HIV] infection status
    human immunodeficiency virus [HIV] disease (B20)

Excludes2 4

These codes carry an Excludes2 note naming B20: its condition is not part of those codes, and both may be reported when the patient has both.

  • Block A50-A64 Infections with a predominantly sexual mode of transmission
    human immunodeficiency virus [HIV] disease (B20)
  • Chapter 3 (D50-D89) Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism
    human immunodeficiency virus [HIV] disease (B20)
  • Block D80-D89 Certain disorders involving the immune mechanism
    human immunodeficiency virus [HIV] disease (B20)
  • Block P35-P39 Infections specific to the perinatal period
    human immunodeficiency virus [HIV] disease (B20)

Code First 6

These codes say to code first a condition named in the note, and B20 is one of the conditions named.

  • B39 Histoplasmosis
    associated AIDS (B20)
  • C46 Kaposi's sarcoma
    any human immunodeficiency virus [HIV] disease (B20)
  • E88.14 HIV-associated lipodystrophy
    any human immunodeficiency virus [HIV] disease (B20)
  • F02 Dementia in other diseases classified elsewhere
    human immunodeficiency virus [HIV] disease (B20)
  • F06.7 Mild neurocognitive disorder due to known physiological condition
    human immunodeficiency virus [HIV] disease (B20)
  • G05 Encephalitis, myelitis and encephalomyelitis in diseases classified elsewhere
    human immunodeficiency virus [HIV] disease (B20)

Use Additional Code 3

These codes say to use an additional code from the note, and B20 is one of the codes named.

  • D59.31 Infection-associated hemolytic-uremic syndrome
    Human immunodeficiency virus [HIV] disease (B20)
  • O98.7 Human immunodeficiency virus [HIV] disease complicating pregnancy, childbirth and the puerperium
    Acquired immune deficiency syndrome (AIDS) (B20)
  • O98.7 Human immunodeficiency virus [HIV] disease complicating pregnancy, childbirth and the puerperium
    Symptomatic HIV disease (B20)

Code Also 1

These codes say B20 may also be needed to fully describe the condition. The note gives no sequencing direction.

  • I27.21 Secondary pulmonary arterial hypertension
    human immunodeficiency virus [HIV] disease (B20)

Index to Diseases and InjuriesGuidance

Alphabetical index entries that point to this code.

  • HIV See Also: Human, immunodeficiency virus; B20

Clinical ClassificationClinical

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

CCSR INF006
HIV infection
Default principal diagnosis: inpatient Yes · outpatient Yes

Clinical InformationClinical

  • Acquired Immunodeficiency Syndrome

    an acquired defect of cellular immunity associated with infection by the human immunodeficiency virus (hiv), a cd4-positive t-lymphocyte count under 200 cells/microliter or less than 14% of total lymphocytes, and increased susceptibility to opportunistic infections and malignant neoplasms. clinical manifestations also include emaciation (wasting) and dementia. these elements reflect criteria for aids as defined by the cdc in 1993.

  • AIDS-Related Complex

    a prodromal phase of infection with the human immunodeficiency virus (hiv). laboratory criteria separating aids-related complex (arc) from aids include elevated or hyperactive b-cell humoral immune responses, compared to depressed or normal antibody reactivity in aids; follicular or mixed hyperplasia in arc lymph nodes, leading to lymphocyte degeneration and depletion more typical of aids; evolving succession of histopathological lesions such as localization of kaposi's sarcoma, signaling the transition to the full-blown aids.

  • HIV Wasting Syndrome

    involuntary weight loss of greater than 10 percent associated with intermittent or constant fever and chronic diarrhea or fatigue for more than 30 days in the absence of a defined cause other than hiv infection. a constant feature is major muscle wasting with scattered myofiber degeneration. a variety of etiologies, which vary among patients, contributes to this syndrome. (from harrison's principles of internal medicine, 13th ed, p1611).

Patient EducationClinical

HIV

HIV stands for human immunodeficiency virus. HIV harms your immune system by destroying a type of white blood cell that helps your body fight infection. This puts you at risk for other infections and diseases.

The full article covers:

  • What is HIV?
  • What is AIDS?
  • How does HIV spread?
  • Who is at risk for HIV infection?
  • What are the symptoms of HIV?
  • How do I know if I have HIV?
  • What are the treatments for HIV?
  • Can HIV infection be prevented?

Read the full article at MedlinePlus

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

Convert B20 to ICD-9-CMHistory

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

ICD-9-CM
042 Human immuno virus dis
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 B20Overview

What is the ICD-10 code for human immunodeficiency virus [HIV] disease?

The ICD-10-CM code for human immunodeficiency virus [HIV] disease is B20. It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

Is B20 (Human immunodeficiency virus [HIV] disease) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report human immunodeficiency virus [HIV] disease on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What MS-DRG does B20 group to?

When human immunodeficiency virus [HIV] disease is the principal diagnosis on an inpatient stay, it groups to MS-DRG 970, 974, 977, 969, 976, 975, with relative weights from 0.7879 to 7.1744 depending on complications. Higher weights mean higher Medicare reimbursement.

Is B20 a CC or MCC?

CMS lists B20 as a CC (complication or comorbidity) for FY 2027. Reported as a secondary diagnosis, it moves the inpatient stay to a higher-weighted DRG within its severity family. It does not count when the principal diagnosis is one of the 5 closely related codes in its exclusion list.

Can B20 be reported with Z21?

Not as a rule. The Excludes1 note on B20 lists "asymptomatic human immunodeficiency virus [HIV] infection status (Z21)". 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 HCC is B20?

B20 (human immunodeficiency virus [HIV] disease) maps to CMS-HCC Category 1 (HIV/AIDS), commonly written as HCC 1, in the CMS-HCC V28 model used for Medicare Advantage risk adjustment in payment year 2027. It mapped to HCC 1 under the retired V24 model. It also maps in the PACE (CMS-HCC V22), ESRD (V21), and ESRD (V24) models. In the Part D prescription drug model it maps to RxHCC 1.

Does B20 risk-adjust for Medicare Advantage payment?

Yes. When documented and reported on a Medicare Advantage encounter, B20 adds a risk adjustment factor of about 0.301 to the beneficiary's RAF score for a community, non-dual, aged enrollee (published V28 weights range from 0.109 to 1.322 depending on the payment segment). HCC 1 sits at the top of its hierarchy, so no other condition category supersedes it. See the full factor table on the HCC 1 category page.