# Hiv question



## trose@prestigebilling.com (Feb 9, 2018)

Please help!

HIV -  If a pt has been treated before for Pneumonia and has HIV and comes back at a later date and is being treated for a broken bone, do we still use B20 or Z21. 

Thank you.
Tammy Rose


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## cgaston (Feb 9, 2018)

These two codes are not interchangeable. 

Z21 is used for asymptomatic HIV positive patients. They are HIV positive but have no manifestations of the disease

B20 is used when their T cells fall below 200 or they develop an "opportunistic infection".  There is a list of these infections on the National Institute of Health website:

https://aids.nlm.nih.gov/topic/1092/hiv-related-conditions


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## michellepilcher (Feb 9, 2018)

Guidelines state:
Patient with HIV disease admitted for unrelated condition:

If a patient with HIV disease is admitted for an unrelated condition (such as traumatic injury), the code for the unrelated condition (e.g., the nature of injury code) should be the principal diagnosis.  Other diagnoses would be B20 for followed by additional diagnosis codes for all reported HIV related conditions

Patients with any known prior diagnosis for an HIV related illness should be coded to B20.  Once a patient has developed an HIV related illness, the patient should be assigned B20 on every subsequent admission /encounter.  Patients previously diagnosed with any HIV illness should never be assigned to R75 or Z21.


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## blaza192 (Feb 9, 2018)

Only certain types of pneumonia count as an opportunistic infection.


If they just say "Patient has HIV and pneumonia." You are only coding Z21 and J18.9.


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