2027 ICD-10-CM Diagnosis Code B97.4Respiratory syncytial virus as the cause of diseases classified elsewhere

ICD-10-CM Codes›A00–B99›B95-B97›B97

ICD-10-CM B97.4
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

B97.4 is a billable ICD-10-CM diagnosis code for respiratory syncytial virus as the cause of diseases classified elsewhere. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 791, 793, 865 through 866. The code is not accepted as a principal diagnosis by the Medicare Code Editor. Coders also document this condition as acute lower respiratory infection caused by respiratory syncytial virus. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Viral infection.

Code Identity

ICD-10-CM Code
B97.4
Billable Status
Yes — Valid for Submission
Code Describes
Respiratory syncytial virus as the cause of diseases classified elsewhere
Short Description
Respiratory syncytial virus causing diseases classd elswhr
Parent Code
B97
Viral agents as the cause of diseases classified elsewhere

Code Classification

ChapterA00–B99Certain infectious and parasitic diseases
SectionB95-B97Bacterial and viral infectious agents
CategoryB97Viral agents as the cause of diseases classified elsewhere
This CodeB97.4Respiratory syncytial virus as the cause of diseases classified elsewhere

Code EditsBilling

Medicare Code Editor checks that affect claim validity for B97.4.

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.

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Acute lower respiratory infection caused by respiratory syncytial virus
  • Acute nasopharyngitis caused by respiratory syncytial virus
  • Acute upper respiratory infection caused by respiratory syncytial virus
  • Acute viral pharyngitis
  • Death associated with respiratory syncytial virus infection
  • Healthcare associated respiratory syncytial virus disease
  • Paramyxoviridae encephalitis
  • Respiratory syncytial virus encephalitis
  • Respiratory syncytial virus infection
  • Respiratory syncytial virus pharyngitis

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to B97.4: its own notes plus those printed at block B95-B97 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.

  • RSV as the cause of diseases classified elsewhere

Excludes1

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

  • acute bronchiolitis due to respiratory syncytial virus (RSV) (J21.0)
  • acute bronchitis due to respiratory syncytial virus (RSV) (J20.5)
  • respiratory syncytial virus (RSV) pneumonia (J12.1)

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.

  • related disorders, such as:
  • otitis media (H65.-)
  • upper respiratory infection (J06.9)

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.-)

Notes

General instructions on how these codes are used.

From Block B95-B97 Bacterial and viral infectious agents applies to 46 codes
  • These categories are provided for use as supplementary or additional codes to identify the infectious agent(s) in diseases classified elsewhere.

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

Referenced in Other NotesGuidance

Instructional notes printed at other codes that name B97.4, its category, or a range that includes it.

Excludes1 1

These codes carry an Excludes1 note naming B97.4: they are not reported together with it, unless the two conditions are unrelated.

  • B34 Viral infection of unspecified site
    viral agents as the cause of diseases classified elsewhere (B97.-) names B97.-, which includes this code

Use Additional Code 53

These codes say to use an additional code from the note, and B97.4 is one of the codes named.

  • J06.9 Acute upper respiratory infection, unspecified
    respiratory syncytial virus (RSV) (B97.4)
  • J95.851 Ventilator associated pneumonia
    code to identify the organism, if known (B95.-, B96.-, B97.-) names B97.-, which includes this code
  • P23.0 Congenital pneumonia due to viral agent
    code (B97) to identify organism names B97, which includes this code
  • E06.0 Acute thyroiditis
    code (B95-B97) to identify infectious agent. names B95-B97, which includes this code
  • G06 Intracranial and intraspinal abscess and granuloma
    code (B95-B97) to identify infectious agent. names B95-B97, which includes this code
  • H65 Nonsuppurative otitis media
    infectious agent (B95-B97) names B95-B97, which includes this code
  • I30.1 Infective pericarditis
    code (B95-B97) to identify infectious agent names B95-B97, which includes this code
  • I33.0 Acute and subacute infective endocarditis
    code (B95-B97) to identify infectious agent names B95-B97, which includes this code
  • I40.0 Infective myocarditis
    code (B95-B97) to identify infectious agent names B95-B97, which includes this code
  • J01 Acute sinusitis
    code (B95-B97) to identify infectious agent. names B95-B97, which includes this code
  • J02.8 Acute pharyngitis due to other specified organisms
    code (B95-B97) to identify infectious agent names B95-B97, which includes this code
  • J03.8 Acute tonsillitis due to other specified organisms
    code (B95-B97) to identify infectious agent. names B95-B97, which includes this code
  • J04 Acute laryngitis and tracheitis
    code (B95-B97) to identify infectious agent. names B95-B97, which includes this code
  • J05 Acute obstructive laryngitis [croup] and epiglottitis
    code (B95-B97) to identify infectious agent. names B95-B97, which includes this code
  • J06.9 Acute upper respiratory infection, unspecified
    code (B95-B97) to identify infectious agent, if known, such as: names B95-B97, which includes this code

38 more Use Additional Code notes name this code. Browse all Use Additional Code notes.

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 INF008
Viral infection
Default principal diagnosis: inpatient No · outpatient No

Patient EducationClinical

Respiratory Syncytial Virus Infections

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.

The full article covers:

  • What is respiratory syncytial virus (RSV)?
  • How is respiratory syncytial virus (RSV) spread?
  • Who is at risk for respiratory syncytial virus (RSV) infections?
  • What are the symptoms of respiratory syncytial virus (RSV) infections?
  • How are respiratory syncytial virus (RSV) infections diagnosed?
  • What are the treatments for respiratory syncytial virus (RSV) infections?
  • Can respiratory syncytial virus (RSV) infections be prevented?

Read the full article at MedlinePlus

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

Convert B97.4 to ICD-9-CMHistory

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

ICD-9-CM
079.6 Resprtry syncytial virus
Approximate The match is approximate rather than exact.

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 B97.4Overview

Is B97.4 (Viral agents as the cause of diseases classified elsewhere) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report respiratory syncytial virus as the cause of diseases classified elsewhere on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What MS-DRG does B97.4 group to?

On inpatient claims, respiratory syncytial virus as the cause of diseases classified elsewhere maps to MS-DRG 793, 791, 866, 865, with relative weights from 0.8691 to 4.2192 depending on complications. Higher weights mean higher Medicare reimbursement.

Can B97.4 be a principal diagnosis?

No. The Medicare Code Editor rejects this code as a principal diagnosis because respiratory syncytial virus as the cause of diseases classified elsewhere describes a circumstance that influences health status rather than a current illness. Report it as a secondary diagnosis.

Can B97.4 be reported with J21.0?

Not as a rule. The Excludes1 note on B97.4 lists "acute bronchiolitis due to respiratory syncytial virus (RSV) (J21.0)". 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 coded first with B97.4?

The Code First note reads: related disorders, such as: otitis media (H65.-); upper respiratory infection (J06.9). When one of these applies, it is sequenced before B97.4.