Excludes1 pair
B20 vs B97.3-
B20 and B97.3 are not coded together. ICD-10-CM declares them mutually exclusive with an Excludes1 note — the two conditions are not expected to occur together, so exactly one of them is normally correct for a given encounter. The Official Guidelines carve out one exception: if the two conditions are clearly unrelated to each other, both may be reported.
The official note, declared on B97.3
Human immunodeficiency virus [HIV] disease (B20)
B20
Human immunodeficiency virus [HIV] disease
Billable
- Chapter 1
- Certain infectious and parasitic diseases
- Section
- B20
Use when the record says
- acquired immune deficiency syndrome [AIDS]
- AIDS-related complex [ARC]
- HIV infection, symptomatic
Indexed under
- AIDS (related complex)
- ARC (AIDS-related complex)
- HIV
- Slim disease (in HIV infection)
- Acquired › immunodeficiency syndrome (AIDS)
B97.3
Retrovirus as the cause of diseases classified elsewhere
Not billable
- Chapter 1
- Certain infectious and parasitic diseases
- Section
- B95-B97
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