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Human immunodeficiency virus [HIV] disease

ICD10CM code

Medical Policies and Guidelines for Human immunodeficiency virus [HIV] disease

Related policies from health plans

Cabenuva (cabotegravir extended-release; rilpivirine extended-release)
Cabenuva (cabotegravir extended-release; rilpivirine extended-release)
Doxorubicin Liposome (Doxil, Lipodox)
Egrifta (tesamorelin)
Gamma Glutamyl Transferase Testing
Fundus Photography
Fuzeon (enfuvirtide)
Growth Hormone
Genotype Testing for Individual Genetic Polymorphisms to Determine Drug-Metabolizer
Laboratory Evaluation of Vitamin B12
Electrodiagnostic Testing (EMG/NCV) - (CPG129)
Outpatient Glycated Hemoglobin and Protein Testing
Respiratory Viral Panel Testing in the Outpatient Setting
Flow Cytometry - (0538)
Serum iron Testing
Sunlenca (lenacapavir)
Trogarzo (ibalizumab-uiyk)
Tropism Testing for HIV Management
Neuropsychological Testing - (EN0258)
Kymriah (tisagenlecleucel) (CG058)
CG-GENE-11 Genotype Testing for Individual Genetic Polymorphisms to Determine Drug-Metabolizer Status
Nucleic Acid Pathogen Testing - (0530)
Nucleic Acid Pathogen Testing - (0530)
Nucleic Acid Pathogen Testing - (0530)
Nucleic Acid Pathogen Testing - (0530)
Nucleic Acid Pathogen Testing - (0530)
Nucleic Acid Pathogen Testing - (0530)
Nucleic Acid Pathogen Testing - (0530)
Nucleic Acid Pathogen Testing - (0530)
Nucleic Acid Pathogen Testing - (0530)
CG-LAB-03 Tropism Testing for HIV Management
CG-LAB-14 Respiratory Viral Panel Testing in the Outpatient Setting
CG-LAB-19 Laboratory Evaluation of Vitamin B12
CG-LAB-21 Serum Iron Testing
CG-LAB-25 Outpatient Glycated Hemoglobin and Protein Testing
CG-LAB-29 Gamma Glutamyl Transferase Testing
CG-MED-47 Fundus Photography
Transthoracic Echocardiography in Children - (0523)
Reconstructive and Cosmetic Surgery
Reconstructive and Cosmetic Surgery(Eff. beginning 1.1.24)
Reconstructive and Cosmetic Surgery(Eff. beginning 2.1.24)
SURG.00116 High Resolution Anoscopy Screening for Anal Intraepithelial Neoplasia (AIN) and Squamous Cell Cancer of the Anus
Concert Genetic Testing: Pharmacogenetics (PDF)
Concert Genetic Testing: Pharmacogenetics (PDF)
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Similar Codes


ICD10CM codes

B20 - Human immunodeficiency virus [HIV] disease
Z20.6 - Contact with and (suspected) exposure to human immunodeficiency virus [HIV]
Z83.0 - Family history of human immunodeficiency virus [HIV] disease
Z21 - Asymptomatic human immunodeficiency virus [HIV] infection status
Z11.4 - Encounter for screening for human immunodeficiency virus [HIV]
B97.35 - Human immunodeficiency virus, type 2 [HIV 2] as the cause of diseases classified elsewhere
Z71.7 - Human immunodeficiency virus [HIV] counseling
R75 - Inconclusive laboratory evidence of human immunodeficiency virus [HIV]
O98.719 - Human immunodeficiency virus [HIV] disease complicating pregnancy, unspecified trimester
O98.7 - Human immunodeficiency virus [HIV] disease complicating pregnancy, childbirth and the puerperium

HCPCS codes

G0432 - Infectious agent antibody detection by enzyme immunoassay (eia) technique, hiv-1 and/or hiv-2, scree
G0433 - Infectious agent antibody detection by enzyme-linked immunosorbent assay (elisa) technique, hiv-1 an
G0435 - Infectious agent antibody detection by rapid antibody test, hiv-1 and/or hiv-2, screening
G0475 - Hiv antigen/antibody, combination assay, screening
U0003 - Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavir
J3485 - Injection, zidovudine, 10 mg
J0850 - Injection, cytomegalovirus immune globulin intravenous (human), per vial
G0472 - Hepatitis c antibody screening, for individual at high risk and other covered indication(s)
G9223 - Pneumocystis jiroveci pneumonia prophylaxis prescribed within 3 months of low cd4+ cell count below
U0005 - Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavir

CPT4 codes

86702 - Antibody; HIV-2
86701 - Antibody; HIV-1
4293F - Patient screened for high-risk sexual behavior (HIV)
3510F - Documentation that tuberculosis (TB) screening test performed and results interpreted (HIV) (IBD)
87806 - Infectious agent antigen detection by immunoassay with direct optical observation; HIV-1 antigen(s),
86689 - Antibody; HTLV or HIV antibody, confirmatory test (eg, Western Blot)
87390 - Infectious agent antigen detection by immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-l
86645 - Antibody; cytomegalovirus (CMV), IgM
86703 - Antibody; HIV-1 and HIV-2, single result
86644 - Antibody; cytomegalovirus (CMV)