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B00.9
ICD-10-CM
Herpes Simplex Virus 1

Find information on Herpes Simplex Virus 1 diagnosis, including clinical documentation, medical coding (ICD-10 code for Herpes Simplex Virus 1, HSV-1 diagnosis code), and healthcare guidelines. Learn about HSV-1 symptoms, testing, treatment, and management for accurate record-keeping and patient care. This resource provides relevant information for healthcare professionals, including physicians, nurses, and medical coders involved in documenting and coding HSV-1 infections.

Also known as

HSV-1
Oral Herpes
Cold Sores
+1 more

Diagnosis Snapshot

Key Facts
  • Definition : Viral infection causing recurrent sores, usually around the mouth.
  • Clinical Signs : Cold sores, blisters, fever, tingling, pain, swollen lymph nodes.
  • Common Settings : Outpatient clinic, telehealth, primary care, emergency department.

Related ICD-10 Code Ranges

Complete code families applicable to AAPC B00.9 Coding
B00.0-B00.9

Herpes simplex [herpesvirus] infections

Infections caused by herpes simplex virus (HSV).

A60.0-A60.9

Anogenital herpesviral [herpes simplex] infections

Herpes simplex virus (HSV) infections affecting the genital and anal areas.

H00.0-H00.1

Herpesviral [herpes simplex] keratitis

Inflammation of the cornea caused by herpes simplex virus (HSV).

G00.0-G00.9

Bacterial meningitis, not elsewhere classified

Meningitis caused by bacteria, not specified elsewhere in the ICD-10.

Code-Specific Guidance

Decision Tree for

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

Is the HSV-1 infection active?

  • Yes

    Site of infection?

  • No

    History of HSV-1 infection?

Code Comparison

Related Codes Comparison

When to use each related code

Description
Herpes simplex virus 1 (HSV-1) infection
Herpes labialis (cold sores)
Herpetic gingivostomatitis
Herpetic whitlow
Herpes simplex virus 2 (HSV-2) infection
Genital herpes
Herpes simplex encephalitis
Neonatal herpes
Eczema herpeticum
Herpes simplex keratitis

Documentation Best Practices

Documentation Checklist
  • HSV-1 diagnosis documentation: Clinical findings
  • HSV-1: Lesion description, location, morphology
  • Diagnostic method: PCR, viral culture, Tzanck smear
  • HSV-1: Symptoms onset, duration, recurrence
  • Medical coding: ICD-10 code for HSV-1 (e.g., B00.1)

Coding and Audit Risks

Common Risks
  • Unspecified Site

    Coding HSV-1 without specifying the affected site (e.g., oral, ocular) leads to inaccurate data and potential claim rejections. Use specific ICD-10 codes.

  • Latency vs. Active

    Incorrectly coding latent HSV-1 as an active infection can skew prevalence data and affect reimbursement. Distinguish between B00.1 and B00.2.

  • Neonatal HSV Miscoding

    Neonatal HSV requires specific codes (P35.0-P35.2) indicating congenital vs. postnatal acquisition. Errors impact public health reporting and care.

Mitigation Tips

Best Practices
  • Accurate ICD-10 coding (e.g., B00.11 for HSV-1 gingivostomatitis)
  • Detailed clinical documentation of lesion site, type, and recurrence
  • Review patient history for prodrome, triggers, and past outbreaks
  • Order appropriate lab tests (PCR, viral culture) for confirmation
  • Educate patients on antiviral therapy, prevention, and transmission

Clinical Decision Support

Checklist
  • 1. Vesicular lesions present? Document location, morphology.
  • 2. Prodromal symptoms (tingling, burning)? ICD-10: B00.9
  • 3. Consider HSV-1 PCR or viral culture. SNOMED CT: 78076005
  • 4. Recurrent infection? Past HSV diagnosis? Document.
  • 5. Patient education: Transmission, recurrence prevention.

Reimbursement and Quality Metrics

Impact Summary
  • HSV-1 reimbursement: ICD-10 B00.1 impacts MS-DRG assignment, affecting hospital payments.
  • Coding accuracy crucial: Correct HSV-1 diagnosis code maximizes claim acceptance, reduces denials.
  • Quality metrics: HSV-1 outbreaks impact patient satisfaction, length of stay, and readmission rates.
  • Hospital reporting: Accurate HSV-1 coding improves infection control tracking and public health data.

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 HSV-1, not just suspicion
  • Distinguish oral vs. other HSV-1 sites
  • Document lesion type for accurate coding
  • Use ICD-10 B00.1 for HSV-1 stomatitis
  • Consider Z86.12 for HSV-1 history

Documentation Templates

Patient presents with complaints consistent with Herpes Simplex Virus 1 (HSV-1) infection.  Onset of symptoms reported as [Date of onset].  Patient exhibits [Location of lesions, e.g., perioral] vesicles characterized by [Description of lesions, e.g., erythema, grouped, small, fluid-filled].  Patient reports associated symptoms of [List symptoms, e.g., tingling, burning, itching, pain, fever, malaise, lymphadenopathy].  Differential diagnosis includes herpes labialis, cold sores, fever blisters, herpetic gingivostomatitis, aphthous stomatitis, and other viral or dermatological conditions.  Physical examination reveals [Objective findings, e.g., tender vesicles on erythematous base, localized edema].  Diagnosis of oral herpes, herpes simplex virus type 1 infection, is made based on clinical presentation.  Treatment plan includes [Medications, e.g., topical antiviral cream such as acyclovir or penciclovir, oral antiviral medication such as valacyclovir],  [Patient education, e.g., regarding viral shedding, transmission prevention, recurrence triggers], and symptomatic management with [Symptom relief measures, e.g., over-the-counter pain relievers, cool compresses].  Patient advised on proper hygiene practices to minimize spread of infection.  Follow-up recommended if symptoms worsen or do not resolve within [Timeframe, e.g., 7-10 days].  ICD-10 code B00.1 (Herpesviral gingivostomatitis and pharyngotonsillitis) or B00.2 (Herpes labialis) may be applicable depending on presentation.  CPT codes for evaluation and management services will be determined based on complexity of visit.