A98.5 vs B33.4
A98.5 and B33.4 can never be reported together. ICD-10-CM declares them mutually exclusive with an Excludes1 note, meaning the two conditions cannot occur in the same patient — so exactly one of them is correct for any given encounter.
The official note, declared on A98.5
hantavirus (cardio)-pulmonary syndrome (B33.4)
A98.5
Hemorrhagic fever with renal syndrome
Billable
- Chapter 1
- Certain infectious and parasitic diseases
- Section
- A90-A99
Use when the record says
- Epidemic hemorrhagic fever
- Korean hemorrhagic fever
- Russian hemorrhagic fever
- Hantaan virus disease
- Hantavirus disease with renal manifestations
- Nephropathia epidemica
- Songo fever
Indexed under
- Hantaan virus disease (Korean hemorrhagic fever)
- Hantavirus disease (with renal manifestations) (Dobrava) (Puumala) (Seoul)
- Nephropathia epidemica
- Nephrosonephritis, hemorrhagic (endemic)
- Fever › epidemic hemorrhagic (inanition) (of unknown origin) (persistent) (with chills) (with rigor)
B33.4
Hantavirus (cardio)-pulmonary syndrome [HPS] [HCPS]
Billable
- Chapter 1
- Certain infectious and parasitic diseases
- Section
- B25-B34
Use when the record says
- Hantavirus disease with pulmonary manifestations
- Sin nombre virus disease
Indexed under
- Sin Nombre virus disease-pulmonary syndrome (Hantavirus) (cardio)
- Disease, diseased › Hantavirus, with pulmonary manifestations
- Disease, diseased › sin nombre virus
- Hantavirus disease › with pulmonary manifestations (with renal manifestations) (Dobrava) (Puumala) (Seoul)
- Syndrome › hantavirus
Excludes1 is not always absolute: where two conditions covered by the note are genuinely unrelated, CMS guidance permits reporting both. Document the reasoning rather than assuming it. More on Excludes1 vs Excludes2 · FY2027