Home Health ICD-9/ICD-10 Alert

Question: We have a patient with a diagnosis of "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 code this?


South Dakota Subscriber

Answer: Code 042 (Human immunodeficiency virus [HIV] disease) indicates that all manifestations of the HIV should follow, so it is correct to follow it with the polyneuropathy code. However, code 357.3 is not the correct code for the neuropathy in this situation, as you ascertained. 
 
HIV is associated with peripheral polyneuropathy, probably due to a vitamin deficiency such as B12. If this is documented, report:
 
• M0230a: 042 (Human immunodeficiency virus [HIV] disease);
• M0240b: 266.2 (Other B-complex deficiencies); and 
• M0240c: 357.4 (Polyneuropathy in other diseases classified elsewhere).

Otherwise code 357.9 (Inflammatory and toxic neuropathy, unspecified), secondary to 042.  

Note: To protect individual privacy, many states prohibit the electronic transmission of ICD-9-CM codes for HIV and sexually transmitted diseases. For more on this topic, see "Aid Your Claims By Avoiding This AIDS Coding Trap" in the April 2005 Home Health ICD-9 Alert.