Facebook tracking pixel
B02.9
ICD-10-CM
Herpes Zoster

Find comprehensive information on Herpes Zoster diagnosis, including clinical documentation, ICD-10-CM codes (B02), medical coding guidelines, and healthcare best practices for managing shingles. Learn about Zoster sine herpete, postherpetic neuralgia, and other related conditions. This resource provides valuable insights for physicians, clinicians, and healthcare professionals involved in the diagnosis and treatment of Herpes Zoster infections. Explore detailed information on symptoms, diagnostic criteria, and treatment options for optimal patient care.

Also known as

Shingles
Zoster

Diagnosis Snapshot

Key Facts
  • Definition : Reactivation of the chickenpox virus (varicella-zoster) causing a painful rash.
  • Clinical Signs : Painful, blistering rash following a nerve path, often on one side of the body. May include fever, headache, fatigue.
  • Common Settings : Primary care, dermatology, urgent care. Antiviral treatment initiated within 72 hours is crucial.

Related ICD-10 Code Ranges

Complete code families applicable to AAPC B02.9 Coding
B02.0-B02.9

Herpes zoster

Infection caused by reactivation of the varicella-zoster virus.

G53.0-G53.9

Nerve root and plexus disorders

Includes pain and other disorders affecting nerve roots and plexuses, sometimes a complication of herpes zoster.

H00-H59

Diseases of the eye and adnexa

Relevant if herpes zoster affects the eye (herpes zoster ophthalmicus).

R20.0-R20.9

Disturbances of skin sensation

Includes altered sensation like pain and itching, which can be a consequence of herpes zoster.

Code-Specific Guidance

Decision Tree for

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

Is the Herpes Zoster confirmed?

  • Yes

    With meningitis?

  • No

    Do not code Herpes Zoster. Code the presenting symptoms.

Code Comparison

Related Codes Comparison

When to use each related code

Description
Shingles: painful rash with blisters
Herpes simplex: cold sores or genital sores
Varicella: chickenpox, widespread itchy rash

Documentation Best Practices

Documentation Checklist
  • Herpes zoster diagnosis documented
  • Clinical presentation: rash characteristics, distribution
  • Location and laterality of rash specified
  • Confirmation method: PCR, Tzanck smear, clinical diagnosis
  • ICD-10-CM code B02. documented appropriately

Coding and Audit Risks

Common Risks
  • Unspecified Site Zoster

    Coding lacks anatomical site, impacting severity and payment. CDI should query for site specificity. Risk of claim denials and inaccurate reporting.

  • Post-herpetic Neuralgia

    PHN coding often missed, leading to underreporting of chronic pain and lost revenue. CDI should review for PHN documentation to ensure accurate coding.

  • Zoster vs. Varicella

    Miscoding between primary varicella and herpes zoster can skew epidemiological data and reimbursements. CDI must ensure clear documentation supports diagnosis.

Mitigation Tips

Best Practices
  • Document dermatomal distribution for accurate ICD-10-CM Zoster coding.
  • Specify affected site (eye, ear) for proper CDI, Zoster billing.
  • Capture pain severity for effective Zoster treatment, HCC coding.
  • Record antiviral prescription, compliance data for risk adjustment.
  • Differentiate Herpes Zoster from simplex for correct diagnosis coding.

Clinical Decision Support

Checklist
  • Unilateral, dermatomal rash: Verify location and distribution
  • Vesicular lesions: Document size, quantity, and stage
  • Pain: Assess type, severity, and location matching rash
  • Neuralgia: Check for allodynia or hyperalgesia
  • Consider age and immunocompetence: Document risk factors

Reimbursement and Quality Metrics

Impact Summary
  • Herpes Zoster reimbursement hinges on accurate ICD-10-CM (B02.-) and appropriate HCPCS/CPT coding for antiviral therapy, pain management, or postherpetic neuralgia treatment. This impacts claim denial rates and overall revenue cycle management.
  • Proper coding and documentation of complications like ophthalmic zoster or disseminated herpes zoster significantly influences MS-DRG assignment and hospital case mix index.
  • Timely and accurate diagnosis coding of Herpes Zoster is crucial for public health surveillance, influencing resource allocation and disease management programs.
  • Quality metrics affected include pain management effectiveness, time to antiviral treatment initiation, and postherpetic neuralgia prevention strategies. These directly impact hospital value-based purchasing programs and performance scores.

Streamline Your Medical Coding

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

Quick Tips

Practical Coding Tips
  • Code confirmed HZ diagnosis B02.
  • Distinguish HZ from varicella B01.
  • Document dermatome, laterality, complications
  • Consider postherpetic neuralgia G53.
  • Check documentation for antiviral Rx

Documentation Templates

Patient presents with a chief complaint of painful rash.  Onset of symptoms began approximately [number] days ago with a prodrome of burning, tingling, or itching sensation localized to the [affected dermatome, e.g., thoracic, ophthalmic, cervical].  The rash is currently characterized by erythematous, maculopapular lesions that have evolved into vesicles clustered in a dermatomal distribution consistent with Herpes Zoster (shingles).  The patient reports [pain level, e.g., mild, moderate, severe] pain described as [pain characteristics, e.g., burning, stabbing, electric].  Pain assessment using a numerical rating scale (NRS) is documented as [NRS score].  Lesions are present on the [specific location, e.g., left flank, right forehead].  No lymphadenopathy is noted.  The patient denies fever, chills, or malaise.  Medical history includes [relevant medical history, e.g., hypertension, diabetes, immunocompromise].  Current medications include [list current medications].  Allergies include [list allergies].  Physical examination reveals [detailed findings related to the rash, including size, distribution, and characteristics of lesions].  Diagnosis of Herpes Zoster is made based on clinical presentation and characteristic dermatomal distribution of the rash.  Differential diagnosis includes contact dermatitis, impetigo, and varicella.  Treatment plan includes antiviral therapy with [medication name and dosage, e.g., acyclovir 800mg five times daily for 7 days] to reduce viral shedding, duration of symptoms, and risk of postherpetic neuralgia.  Pain management is addressed with [pain management plan, e.g., over-the-counter analgesics, prescription pain medication].  Patient education provided regarding contagious nature of the virus, proper hygiene, and potential complications such as postherpetic neuralgia.  Follow-up appointment scheduled in [timeframe] to assess treatment response and monitor for complications.  ICD-10 code B02.  
Herpes Zoster - AI-Powered ICD-10 Documentation