B97.4 - Respiratory syncytial virus as the cause of diseases classified elsewhere
|Short Description:||Respiratory syncytial virus causing diseases classd elswhr|
|Long Description:||Respiratory syncytial virus as the cause of diseases classified elsewhere|
|Status:||Valid for Submission|
B97.4 is a billable ICD-10 code used to specify a medical diagnosis of respiratory syncytial virus as the cause of diseases classified elsewhere. The code is valid during the fiscal year 2023 from October 01, 2022 through September 30, 2023 for the submission of HIPAA-covered transactions.
This code describes a circumstance which influences the patient's health status but not a current illness or injury. The code is unacceptable as a principal diagnosis.
The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:
- Healthcare associated respiratory syncytial virus disease
- Respiratory syncytial virus encephalitis
- Respiratory syncytial virus infection
- Respiratory syncytial virus pharyngitis
Tabular List of Diseases and Injuries
The Tabular List of Diseases and Injuries is a list of ICD-10 codes, organized "head to toe" into chapters and sections with coding notes and guidance for inclusions, exclusions, descriptions and more. The following references are applicable to this diagnosis code:
Inclusion TermsInclusion Terms
These terms are the conditions for which that code is to be used. The terms may be synonyms of the code title, or, in the case of "other specified" codes, the terms are a list of the various conditions assigned to that code. The inclusion terms are not necessarily exhaustive. Additional terms found only in the Alphabetic Index may also be assigned to a code.
- RSV as the cause of diseases classified elsewhere
Code FirstCode First
Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. For such conditions, the ICD-10-CM has a coding convention that requires the underlying condition be sequenced first followed by the manifestation. Wherever such a combination exists, there is a "use additional code" note at the etiology code, and a "code first" note at the manifestation code. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation.
Type 1 ExcludesType 1 Excludes
A type 1 excludes note is a pure excludes note. It means "NOT CODED HERE!" An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. An Excludes1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.
Index to Diseases and Injuries References
The Index to Diseases and Injuries is an alphabetical listing of medical terms, with each term mapped to one or more ICD-10 code(s). The following references for this diagnosis code are found in the injuries and diseases index:
- - Respiratory - See Also: condition;
- - syncytial virus, as cause of disease classified elsewhere - See Also: Virus, respiratory syncytial (RSV); - B97.4
The Medicare Code Editor (MCE) detects and reports errors in the coding of claims data. The following ICD-10 Code Edits are applicable to this code:
- Unacceptable principal diagnosis - There are selected codes that describe a circumstance which influences an individual's health status but not a current illness or injury, or codes that are not specific manifestations but may be due to an underlying cause. These codes are considered unacceptable as a principal diagnosis.
Convert to ICD-9 Code
|Source ICD-10 Code||Target ICD-9 Code|
|B97.4||079.6 - Resprtry syncytial virus|
|Approximate Flag - The approximate mapping means there is not an exact match between the ICD-10 and ICD-9 codes and the mapped code is not a precise representation of the original code.|
Respiratory Syncytial Virus Infections
What is respiratory syncytial virus (RSV)?
Respiratory syncytial virus, or RSV, is a common respiratory virus. It usually causes mild, cold-like symptoms. But it can cause serious lung infections, especially in infants, older adults, and people with serious medical problems.
How is respiratory syncytial virus (RSV) spread?
RSV spreads from person to person through:
- The air by coughing and sneezing
- Direct contact, such as kissing the face of a child who has RSV
- Touching an object or surface with the virus on it, then touching your mouth, nose, or eyes before washing your hands
People who have an RSV infection are usually contagious for 3 to 8 days. But sometimes infants and people with weakened immune systems can continue to spread the virus for as long as 4 weeks.
Who is at risk for respiratory syncytial virus (RSV) infections?
RSV can affect people of all ages. But it is very common in small children; nearly all children become infected with RSV by age 2. In the United States, RSV infections usually occur during fall, winter, or spring.
Certain people are at higher risk of having a severe RSV infection:
- Older adults, especially those age 65 and older
- People with chronic medical conditions such as heart or lung disease
- People with weakened immune systems
What are the symptoms of respiratory syncytial virus (RSV) infections?
The symptoms of RSV infection usually start about 4 to 6 days after infection. They include:
- Runny nose
- Decrease in appetite
These symptoms usually appear in stages instead of all at once. In very young infants, the only symptoms may be irritability, decreased activity, and trouble breathing.
RSV can also cause more severe infections, especially in people at high risk. These infections include bronchiolitis, an inflammation of the small airways in the lung, and pneumonia, an infection of the lungs.
How are respiratory syncytial virus (RSV) infections diagnosed?
Your health care provider may use many tools to make a diagnosis:
- A medical history, including asking about symptoms
- A physical exam
- A lab test of nasal fluid or another respiratory specimen to check for RSV. This is usually done for people with severe infection.
- Tests to check for complications in people with severe infection. The tests may include a chest x-ray and blood and urine tests.
What are the treatments for respiratory syncytial virus (RSV) infections?
There is no specific treatment for RSV infection. Most infections go away on their own in a week or two. Over-the-counter pain relievers can help with the fever and pain. However, do not give aspirin to children. And do not give cough medicine to children under four. It is also important to get enough fluids to prevent dehydration.
Some people with severe infection may need to be hospitalized. There, they might get oxygen, a breathing tube, or a ventilator.
Can respiratory syncytial virus (RSV) infections be prevented?
There are no vaccines for RSV. But you may able to reduce your risk of getting or spreading an RSV infection by:
- Washing your hands often with soap and water for at least 20 seconds
- Avoiding touching your face, nose, or mouth with unwashed hands
- Avoiding close contact, such as kissing, shaking hands, and sharing cups and eating utensils, with others if you are sick or they are sick
- Cleaning and disinfecting surfaces that you frequently touch
- Covering coughs and sneezes with a tissue. Then throw away the tissue and wash your hands
- Staying home when sick
Centers for Disease Control and Prevention
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- FY 2023 - No Change, effective from 10/1/2022 through 9/30/2023
- FY 2022 - No Change, effective from 10/1/2021 through 9/30/2022
- FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
- FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
- FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
- FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
- FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
- FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016 (First year ICD-10-CM implemented into the HIPAA code set)