Inpatient Facility Coding & Compliance Alert
Current Results Can Trump Previous HIV Positive Test
Question: A two-year-old child was admitted with pneumonia due to respiratory syncytial virus (RSV). The child’s history includes prematurity and being HIV positive. He was treated with Ribavarin and bronchodilators. All blood work was normal, and the HIV test was negative. What is the best way to code everything, especially with the different HIV test result?
Answer: The primary diagnosis should be 480.1 (Pneumonia due to respiratory syncytial virus), with a secondary diagnosis of V01.79 (Contact or exposure to other viral diseases).
The patient might be the child of an HIV parent, which would explain why his initial labs might have been positive for HIV. More than likely, he was treated for the infection.
In cases of patients with HIV, you’re allowed to look at their history to determine whether 042 (Human immunodeficiency virus [HIV] disease) or V08 (Asymptomatic human immunodeficiency virus [HIV] infection status) applies. Because this patient’s HIV test is now negative, you should not code with V08. You also should not report 042 since you must have documentation of the AIDS before submitting the diagnosis.
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Inpatient Facility Coding & Compliance Alert
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