Hepatitis C ICD-10-CM codes

Hepatitis C is split by acuity. B18.2 (chronic viral hepatitis C) is the code used for most patients under treatment or surveillance. B17.10 is acute hepatitis C without hepatic coma and B17.11 acute with hepatic coma. When the record says only hepatitis C with no acuity, assign B19.20 (unspecified viral hepatitis C without hepatic coma) or B19.21 with hepatic coma; do not default to chronic.

The fifth character distinguishes hepatic coma. Hepatic encephalopathy documented with hepatitis C is captured by the with-coma code, so do not add K72.9- for the encephalopathy on top of B17.11 or B19.21. Cirrhosis (K74.60, or K74.69 for a specified type) and hepatocellular carcinoma (C22.0) are coded separately in addition to the hepatitis code, and the sequencing depends on which condition is the focus of the encounter.

A positive antibody test in an asymptomatic patient is coded B19.20 only once the provider confirms infection. Screening in a patient with no symptoms or known exposure is Z11.59. After successful antiviral treatment with a sustained virologic response, the provider may document hepatitis C as cured; from then on report Z86.19 (personal history of other infectious and parasitic diseases) rather than an active B18.2 code. The term carrier of hepatitis C indexes to B18.2 because ICD-10-CM treats a carrier state as chronic infection.