Inpatient Facility Coding & Compliance Alert
Ace Coding For HIV Tests
Question: A two-year old infant was admitted with pneumonia due to respiratory syncytial virus. The patient’s history includes prematurity and HIV positive. The patient was treated with ribavarin and bronchodilators. All blood work was normal; HIV test was negative.
What will be the primary diagnosis in this scenario? Also, if the patient was HIV positive, should I use the code 042 or V08 despite the new HIV test being negative?
Massachusetts Subscriber
Answer: The primary diagnosis code would be 480.1 (Pneumonia due to respiratory syncytial virus). This infant may be of HIV-positive parents and thus the initial laboratory tests must have been positive for HIV. The patient was treated and now the child is negative for HIV. Therefore, you cannot code V08 (Asymptomatic human immunodeficiency virus (HIV) infection status).
Also, you cannot code 042 (Human immunodeficiency virus [HIV] disease) because AIDS should be documented in order to report this code.
Inpatient Facility Coding & Compliance Alert
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