Pediatric Coding Alert

Good news: Code 079.99 has a one-to-one relationship.

Pediatricians treat viral infections—which are caused by a virus in the body—nearly every day. Viral infections cannot be treated with antibiotics, but the patient’s immune system can usually fight the infection when paired with proper hydration, diet, and rest.

Right now, you’ll report unspecified viral infections with 079.99 (Unspecified viral infection).

ICD-10: When your diagnosis system changes next year, that code will become B97.89 (Other viral agents as the cause of diseases classified elsewhere). ICD-10 includes only one “straight crossover” diagnosis, but has many specific diagnoses for bacterial and viral infectious agents.

You’ll also find the diagnosis in a different section of ICD-10. ICD-9-CM lists unspecified viral infection in the Infectious and Parasitic Diseases section, Other Diseases Due to Viruses and Chlamydiae subsection. ICD-10 lists the condition at the end of the Bacterial and Viral Infectious Agents section.

Documentation: Pediatricians will need to be more detailed in their documentation of viral infections so you can assign a more specific diagnosis whenever possible. Although the ICD-10 descriptor does not include the verbiage “unspecified,” B97.89 will still function as a type of catch-all diagnosis for cases that don’t fit elsewhere. Some payers might not reimburse for “unspecified” codes, so the same might hold true with B97.89. The more detailed the practitioner’s documentation can be, the better your chances of correct coding and reimbursement. 

Coder Tips: On your superbill and/or favorites in your EHR, after unspecified viral infection, list B97.89. Include notations about the expanded diagnosis family and the available options to prompt the pediatrician to enter the necessary information.