Home Health ICD-9/ICD-10 Alert

Question: The medical record said "polyneuropathy of the extremities due to AIDS." The clinician recommended the AIDS diagnosis code (042) with 357.3 (Polyneuropathy in malignant disease), but the ICD-9 manual indicates that 357.3 is only reportable with codes 140.0-208.9. How should I report this claim?

Texas Subscriber

Answer: Your suspicion is warranted: 357.3 is only reportable with the primary diagnosis codes that indicate malignant neoplasms and leukemia. Because AIDS is not a malignant disease, you should report 042 (Human immunodeficiency virus [HIV] disease) followed by a diagnosis of 357.4 (Polyneuropathy in other diseases classified elsewhere).

Although you might think you should list 357.4 as the primary diagnosis because the clinician is actually treating the polyneuropathy and not the HIV, you shouldn't. Don't forget: A note in ICD-9 following 357.4 instructs coders to "code first underlying disease."

Nice work deciding on 042 instead of V08 (Asymptomatic HIV infection status), V01.7 (Exposure to HIV virus) and 795.71 (Nonspecific serologic evidence of HIV). You should assign code 042 for all types of confirmed HIV infection, whereas you would use 795.71 when a patient, including an infant, has inconclusive HIV test results and V08 when a patient with documented asymptomatic HIV infection has never had an HIV-related illness.