Viral agents as the cause of diseases classified elsewhere
In Bacterial and viral infectious agents (B95-B97), chapter 1: Certain Infectious and Parasitic Diseases
20 billable codes under B97: 4 are a CC; 1 map to HCC 1 (HIV/AIDS).A CC or MCC (major CC) is a secondary diagnosis that raises the MS-DRG payment. An HCC counts toward a Medicare Advantage patient's risk score.
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Official coding guidelines
From the ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027 (CMS and NCHS). Links open the PDF at the right page.
- Section I.C.1.b Infectious agents as the cause of diseases classified to other chapters (page 22), covers B97
When an infection coded outside Chapter 1 does not name the organism, add a code from category B95, B96, or B97 to identify it.
Other Chapter 1 topics:
- Human Immunodeficiency Virus (HIV) Infections (page 19)
- Infections resistant to antibiotics (page 22)
- Sepsis, Severe Sepsis, and Septic Shock (page 23)
- Methicillin Resistant Staphylococcus aureus (MRSA) Conditions (page 27)
- Zika virus infections (page 28)
- Coronavirus infections (page 28)
All codes under B97
B97 can't be used on a claim. Pick a billable code below; grey headings group them.
- B97.0Adenovirus as the cause of diseases classified elsewhere
- B97.1Enterovirus as the cause of diseases classified elsewhere
- B97.10Unspecified enterovirus as the cause of diseases classified elsewhere
- B97.11Coxsackievirus as the cause of diseases classified elsewhere
- B97.12Echovirus as the cause of diseases classified elsewhere
- B97.19Other enterovirus as the cause of diseases classified elsewhere
- B97.2Coronavirus as the cause of diseases classified elsewhere
- B97.21SARS-associated coronavirus as the cause of diseases classified elsewhere
- B97.29Other coronavirus as the cause of diseases classified elsewhere
- B97.3Retrovirus as the cause of diseases classified elsewhere
- B97.30Unspecified retrovirus as the cause of diseases classified elsewhere
- B97.31Lentivirus as the cause of diseases classified elsewhere
- B97.32Oncovirus as the cause of diseases classified elsewhere
- B97.33Human T-cell lymphotrophic virus, type I [HTLV-I] as the cause of diseases classified elsewhere
- B97.34Human T-cell lymphotrophic virus, type II [HTLV-II] as the cause of diseases classified elsewhere
- B97.35Human immunodeficiency virus, type 2 [HIV 2] as the cause of diseases classified elsewhere
- B97.39Other retrovirus as the cause of diseases classified elsewhere
- B97.4Respiratory syncytial virus as the cause of diseases classified elsewhere
- B97.5Reovirus as the cause of diseases classified elsewhere
- B97.6Parvovirus as the cause of diseases classified elsewhere
- B97.7Papillomavirus as the cause of diseases classified elsewhere
- B97.8Other viral agents as the cause of diseases classified elsewhere
- B97.81Human metapneumovirus as the cause of diseases classified elsewhere
- B97.89Other viral agents as the cause of diseases classified elsewhere
B97 MS-DRGs
As the principal diagnosis, the billable codes under B97 group to MS-DRG 865, 866, 791, or 793 (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.
- DRG 865 Viral Illness with MCC (20 of 20 codes)
- DRG 866 Viral Illness without MCC (20 of 20 codes)
- DRG 791 Prematurity with Major Problems (1 of 20 codes)
- DRG 793 Full Term Neonate with Major Problems (1 of 20 codes)
Other codes that refer to B97
Notes on these codes point to B97.
- B34 Excludes1: viral agents as the cause of diseases classified elsewhere (B97.-)
- E06.0 Use Additional Code: code (B95-B97) to identify infectious agent.
- G06 Use Additional Code: code (B95-B97) to identify infectious agent.
- H65 Use Additional Code: infectious agent (B95-B97)
- I30.1 Use Additional Code: code (B95-B97) to identify infectious agent
- I33.0 Use Additional Code: code (B95-B97) to identify infectious agent
- I40.0 Use Additional Code: code (B95-B97) to identify infectious agent
- J01 Use Additional Code: code (B95-B97) to identify infectious agent.
- J02.8 Use Additional Code: code (B95-B97) to identify infectious agent
- J03.8 Use Additional Code: code (B95-B97) to identify infectious agent.
- J04 Use Additional Code: code (B95-B97) to identify infectious agent.
- J05 Use Additional Code: code (B95-B97) to identify infectious agent.
- J06.9 Use Additional Code: code (B95-B97) to identify infectious agent, if known, such as:
- J32 Use Additional Code: infectious agent (B95-B97)
- J36 Use Additional Code: code (B95-B97) to identify infectious agent.
- J37 Use Additional Code: infectious agent (B95-B97)
- J85 Use Additional Code: code (B95-B97) to identify infectious agent.
- J86 Use Additional Code: code (B95-B97) to identify infectious agent.
- J95.851 Use Additional Code: code to identify the organism, if known (B95.-, B96.-, B97.-)
- K65 Use Additional Code: code (B95-B97), to identify infectious agent, if known
About the condition
Plain-language background from MedlinePlus (National Library of Medicine), not coding guidance.
Viral Infections
Viruses are very tiny germs. They are made of genetic material (either DNA or RNA) inside of a protein coating. There are a huge number of viruses on earth. Only a small number of them can infect humans. Those viruses can infect our cells, which may cause disease. Some of the diseases that viruses can cause include the common cold, the flu, COVID-19, and HIV.
Read more about viral infections on MedlinePlusCode history
Valid since FY2016, when ICD-10-CM took effect on October 1, 2015. No changes since.