ED Coding and Reimbursement Alert

Question: Encounter notes indicate that the ED physician treated a patient with “acute hepatitis B.” How do I choose an ICD-10 code for this condition? I see there are several hepatitis B entries to choose from.

Oklahoma Subscriber

Answer: You’ll choose a diagnosis from one of the following codes, depending on encounter specifics:

• B16.0 (Acute hepatitis B with delta-agent with hepatic coma)
• B16.1 (Acute hepatitis B with delta-agent without hepatic coma)
• B16.2 (Acute hepatitis B without delta-agent with hepatic coma)
• B16.9 (Acute hepatitis B without delta-agent and without hepatic coma)

With/without delta-agent: When a patient suffers from hepatitis B with delta-agent, it’s kind of like a super-hepatitis. It is an infection that features both hepatitis B and hepatitis D. Remember, hepatitis D cannot propagate unless the patient already has hepatitis B.

With/without hepatic coma: You might also see hepatic coma referred to as hepatic encephalopathy. There is a severe decline in brain function due to hepatitis in hepatic coma patients. This is because the liver can’t remove toxins from the blood, which can cause buildup of ammonia or other substances that can harm brain function.