Primary Care Coding Alert

Question: Our provider saw one of our pediatric patients who had a fever and a bad rash on her belly and chest. The diagnosis was roseola infantum, but when I coded B08.21, the auditor said it wasn’t the right choice. I’ve seen this condition a handful of times over the years, and always have used that code with no problem. Did ICD-10 update the coding for this?

Delaware Subscriber

Answer: First, ICD-10 did not make any changes to these codes this year. Reporting B08.21 (Exanthema subitum [sixth disease] due to human herpesvirus 6) will be correct in many cases, but it requires the documentation show human herpesvirus 6 to be the infectious agent.

For proper coding, consider the following: There are three possible codes for reporting roseola infantum, also known as sixth disease, B08.20 (Exanthema subitum [sixth disease], unspecified), B08.21, and B08.22 (Exanthema subitum [sixth disease] due to human herpesvirus 7). The 5th character specifies the infectious agent, so you’ll generally want to turn to the unspecified code, B08.20, when that information is not known. If you see that the provider ordered tests and the results are available, query the provider for clarification in the interest of coding to the highest specificity.