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B18.2
ICD-10-CM
Hepatitis C

Find comprehensive information on Hepatitis C diagnosis including ICD-10 codes (B17.1, B18.2), SNOMED CT concepts, clinical documentation improvement (CDI) best practices, and healthcare guidelines for accurate medical coding and billing. Learn about Hepatitis C virus (HCV) antibody testing, RNA testing, liver function tests (LFTs), and the stages of chronic Hepatitis C infection for proper diagnosis documentation. This resource provides valuable insights for physicians, healthcare providers, medical coders, and CDI specialists seeking to optimize clinical documentation and ensure accurate Hepatitis C diagnosis reporting.

Also known as

HCV
Hep C

Diagnosis Snapshot

Key Facts
  • Definition : Liver infection caused by the hepatitis C virus, often asymptomatic initially but can lead to chronic liver disease.
  • Clinical Signs : Fatigue, jaundice, abdominal pain, nausea, dark urine. Many cases are asymptomatic.
  • Common Settings : Primary care, gastroenterology, hepatology, infectious disease clinics, substance abuse treatment centers.

Related ICD-10 Code Ranges

Complete code families applicable to AAPC B18.2 Coding
B17.1

Acute hepatitis C

New onset hepatitis C infection.

B18.2

Chronic viral hepatitis C

Long-standing hepatitis C infection.

B19.10

Unspecified viral hepatitis C without hepatic coma

Hepatitis C without coma, not specified as acute or chronic.

B19.11

Unspecified viral hepatitis C with hepatic coma

Hepatitis C with coma, not specified as acute or chronic.

Code-Specific Guidance

Decision Tree for

Follow this step-by-step guide to choose the correct ICD-10 code.

Is the Hepatitis C active (acute or chronic)?

  • Yes

    Is it chronic Hepatitis C?

  • No

    Is it unspecified Hepatitis C?

Code Comparison

Related Codes Comparison

When to use each related code

Description
Hepatitis C
Alcoholic Hepatitis
Autoimmune Hepatitis

Documentation Best Practices

Documentation Checklist
  • Hepatitis C diagnosis documentation: ICD-10-CM code
  • Document HCV antibody test results (positive/negative)
  • HCV RNA test: qualitative and quantitative results
  • Liver function tests (ALT, AST, bilirubin) values
  • Document genotype and subtype if available

Coding and Audit Risks

Common Risks
  • Unspecified Hepatitis C

    Coding with unspecified codes (B17.10, B18.2) when clinical documentation supports a more specific diagnosis like chronic or acute Hepatitis C.

  • Unconfirmed Active Infection

    Incorrectly assigning active infection codes (B18.2) without documented evidence of viral replication or liver inflammation.

  • Missing Liver Damage Codes

    Failing to code associated liver conditions like fibrosis or cirrhosis (K70.3, K74.6) when documented alongside Hepatitis C.

Mitigation Tips

Best Practices
  • Code HCV screenings accurately using ICD-10-CM Z13.320.
  • Document risk factors for HCC in patients with HCV for accurate HCC coding.
  • Ensure compliant HCV testing & diagnosis documentation for accurate reimbursement.
  • Query physicians for clarification on HCV-related liver disease severity for proper CDI.
  • Use SNOMED CT codes for precise HCV diagnosis documentation & data analysis.

Clinical Decision Support

Checklist
  • 1. Documented HCV antibody test (ICD-10 Z13.2)
  • 2. If positive, HCV RNA test ordered/reviewed (CPT 87521)
  • 3. Assess fibrosis stage via approved method
  • 4. Document prior treatments and responses (SNOMED CT 386053000)
  • 5. Review/address risk factors (drug use, transfusions)

Reimbursement and Quality Metrics

Impact Summary
  • Hepatitis C reimbursement hinges on accurate ICD-10-CM (B17.-, B18.2) and CPT coding for lab tests, procedures, and antiviral therapies. Impacts: optimized coding maximizes payments, reduces denials.
  • Quality metrics for Hepatitis C focus on sustained virologic response (SVR). Accurate documentation and reporting are crucial for performance-based reimbursement and public health reporting. Impacts: improved patient outcomes, enhanced hospital reputation.
  • Timely filing and claims management are critical for Hepatitis C reimbursements. Delays can lead to denied or reduced payments. Impacts: accelerated cash flow, minimized revenue cycle management costs.
  • Monitoring key performance indicators (KPIs) like SVR rates, treatment completion rates, and linkage to care enhances Hepatitis C quality metrics. Impacts: demonstrates value-based care delivery, attracts better insurance contracts.

Streamline Your Medical Coding

Let S10.AI help you select the most accurate ICD-10 codes for . Our AI-powered assistant ensures compliance and reduces coding errors.

Quick Tips

Practical Coding Tips
  • Code confirmed HCV, not exposure
  • ICD-10-CM B18.2 or B17.1
  • Document genotype/viral load
  • Distinguish acute vs chronic
  • Check for liver damage codes

Documentation Templates

Patient presents with signs and symptoms suggestive of Hepatitis C infection.  Presenting complaints may include fatigue, jaundice, abdominal pain, nausea, and dark urine.  Patient history includes possible risk factors for Hepatitis C Virus (HCV) such as past intravenous drug use, blood transfusion prior to 1992, long-term hemodialysis, occupational exposure to blood, or birth to an HCV-positive mother.  Physical examination may reveal hepatomegaly or splenomegaly.  Initial laboratory testing includes HCV antibody testing.  A positive HCV antibody test indicates past or current HCV infection and necessitates further testing.  HCV RNA testing is performed to confirm active infection.  If HCV RNA is detected, HCV genotype testing is performed to guide treatment decisions.  Liver function tests (LFTs), including ALT, AST, and alkaline phosphatase, are also evaluated to assess liver damage.  Fibrosis assessment is performed using transient elastography or liver biopsy to stage the disease and guide treatment.  Diagnosis of chronic hepatitis C is confirmed by positive HCV RNA and elevated liver enzymes, indicating active viral replication and liver inflammation.  Treatment options for chronic Hepatitis C include direct-acting antiviral agents (DAAs) tailored to the patient's genotype and fibrosis stage.  Treatment goals include achieving sustained virologic response (SVR), defined as undetectable HCV RNA 12 weeks after completing treatment, effectively indicating viral eradication.  Patient education regarding transmission prevention, medication adherence, and follow-up care is crucial.  Further monitoring of liver function and HCV RNA levels during and after treatment is necessary to assess treatment response and identify potential complications such as cirrhosis or hepatocellular carcinoma.  ICD-10 codes for Hepatitis C may include B18.2, B17.10, or B19.10, depending on the specific manifestation.  Appropriate CPT codes for diagnostic and treatment procedures will be documented based on services rendered.