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B02.9
ICD-10-CM
Herpes Zoster (Shingles)

Find comprehensive information on Herpes Zoster (shingles) diagnosis, including clinical documentation, ICD-10 codes (B02), medical coding guidelines, and healthcare resources. Learn about zoster-related pain management, antiviral treatment, postherpetic neuralgia, and other complications. This resource provides essential information for physicians, healthcare providers, and medical coders seeking accurate and up-to-date guidance on Herpes Zoster.

Also known as

Shingles
Zoster
Herpes Zoster

Diagnosis Snapshot

Key Facts
  • Definition : Reactivation of the chickenpox virus (varicella-zoster) causing a painful rash.
  • Clinical Signs : Painful, blistering rash, usually on one side of the body. May include fever, headache, fatigue.
  • Common Settings : Primary care, urgent care, dermatology, pain clinics.

Related ICD-10 Code Ranges

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

Herpes zoster

Codes for various locations and complications of shingles.

G53.0-G53.9

Peripheral nerve disorders

Includes postherpetic neuralgia, a common complication of shingles.

H00-H59

Disorders of the eye and adnexa

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

Code-Specific Guidance

Decision Tree for

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

Is the diagnosis Herpes Zoster (Shingles)?

  • Yes

    With meningitis?

  • No

    Do not code as Herpes Zoster. Review diagnosis.

Code Comparison

Related Codes Comparison

When to use each related code

Description
Shingles (Herpes Zoster)
Herpes Simplex
Contact Dermatitis

Documentation Best Practices

Documentation Checklist
  • Shingles diagnosis documentation: ICD-10-CM code B02
  • Document affected dermatome location precisely.
  • Describe lesion morphology (e.g., vesicles, crusts).
  • Note presence of pain (neuralgia) type and severity.
  • Record antiviral therapy details: drug, dosage, duration.

Coding and Audit Risks

Common Risks
  • Unspecified Site Zoster

    Coding Herpes Zoster without site specificity when documented, leading to inaccurate severity and resource reflection. Impacts DRG and quality reporting.

  • Post-Herpetic Neuralgia

    Missing or delayed diagnosis coding for post-herpetic neuralgia, affecting appropriate treatment and reimbursement for pain management.

  • Zoster vs. Chickenpox

    Incorrectly coding chickenpox (Varicella) as Herpes Zoster or vice-versa, resulting in inaccurate epidemiological data and resource allocation.

Mitigation Tips

Best Practices
  • Accurate ICD-10-CM coding: B02.x for Shingles diagnosis.
  • Document rash location, character, associated pain for CDI.
  • Thorough HPI crucial: Onset, duration, symptoms, prior chickenpox.
  • Consider HZ complications: Postherpetic neuralgia, ophthalmic HZ.
  • Check immunization status for zoster vaccine in documentation.

Clinical Decision Support

Checklist
  • 1. Unilateral, dermatomal rash: Verify location and distribution.
  • 2. Pain: Assess type, severity, and preceding onset.
  • 3. Vesicular lesions: Document size, quantity, and stage.
  • 4. Consider age and immunocompetence: Check patient history.
  • 5. Confirm diagnosis: PCR or direct fluorescent antibody (DFA).

Reimbursement and Quality Metrics

Impact Summary
  • Shingles reimbursement hinges on accurate ICD-10-CM coding (B02.x) and proper documentation of complications for optimal payment.
  • Quality metrics impacted: Herpes Zoster vaccination rates, pain management, post-herpetic neuralgia incidence tracking.
  • Timely antiviral therapy initiation and pain assessment crucial for positive patient outcomes and value-based care success.
  • Coding accuracy directly impacts hospital reporting on shingles cases, influencing resource allocation and public health initiatives.

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 B02.x for zoster, add site
  • Use Z86.11 for HZO history
  • Document rash location, stage

Documentation Templates

Patient presents with a chief complaint of painful rash.  Onset of the rash was reported [Number] days ago, initially characterized as burning, tingling, or itching (paresthesia) in the affected dermatome.  The rash is now described as erythematous, maculopapular, and quickly evolving into vesicles clustered in a dermatomal distribution consistent with Herpes Zoster (shingles).  Location of the rash is documented as [Location, e.g., left thoracic dermatome T5-T7].  Patient reports pain level as [Pain scale rating, e.g., 7/10] described as [Pain descriptors, e.g., sharp, burning, stabbing].  Associated symptoms may include fever, headache, malaise, and lymphadenopathy.  The patient [Positive/Negative] for a prior history of chickenpox (Varicella Zoster Virus).  No known immunocompromising conditions were reported.  Physical exam confirms the presence of a vesicular rash in a dermatomal pattern without involvement of the eye or other cranial nerves.  Diagnosis of Herpes Zoster (shingles) is made based on clinical presentation and history.  Treatment plan includes antiviral therapy with [Medication name and dosage, e.g., Valacyclovir 1000mg TID for 7 days] to reduce viral shedding, lessen the duration of symptoms, and decrease the risk of postherpetic neuralgia.  Patient education provided on pain management strategies including [Pain management strategies, e.g., over-the-counter analgesics, cool compresses], hygiene to prevent the spread of infection, and potential complications like postherpetic neuralgia.  Follow-up appointment scheduled in [Duration, e.g., one week] to monitor symptom resolution and assess for complications.  ICD-10-CM code B02. [Specify subtype if applicable, e.g., B02.2 for Herpes Zoster with meningitis] is assigned.  Appropriate Zoster vaccine information and counseling provided per CDC guidelines.
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