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ICD-10-CM B20: Human immunodeficiency virus [HIV] disease

B20 is the billable ICD-10-CM code for human immunodeficiency virus [HIV] disease, in category B20 (Human immunodeficiency virus [HIV] disease) of the Human immunodeficiency virus [HIV] disease section. As a principal diagnosis it groups to MS-DRG 969 HIV with Extensive O.R. Procedures with MCC, MS-DRG 970 HIV with Extensive O.R. Procedures without MCC, MS-DRG 971 (MDC 25 MDC 25: Human Immunodeficiency Virus Infections). It maps to HCC 1 (HIV/AIDS) in CMS-HCC V28. As a secondary diagnosis it is a CC, excluded with 5 principal diagnoses. 43 LCD billing and coding articles list it as covered.

Compiled from CMS files by the QuickIntell RCM Editorial Team · Data effective · Method: reference methodology · Report a data correction

Data currency: ICD-10-CM code descriptions: FY2027 (effective October 1, 2026); IPPS Table 5 (MS-DRG weights): v44 FY2027 (final rule + CN3) (effective October 1, 2026); ICD-10-CM to HCC mapping: PY2027 initial ICD-10-CM mappings (dates of service 2026) (payment year 2027); Medicare Coverage Database billing and coding articles: MCD release October 8, 2026 (effective October 4, 2026). Next CMS release: FY2028 code files, effective October 1, 2027 for the ICD-10-CM code descriptions; FY2028 final rule (August 2027), effective October 1, 2027; an April 1 interim grouper update when CMS issues one for the IPPS Table 5 (MS-DRG weights); PY2028 advance notice (February 2027) and the PY2027 midyear final mapping (spring 2027) for the ICD-10-CM to HCC mapping; weekly, every Thursday for the Medicare Coverage Database billing and coding articles.

Code
B20
billable FY2027 ICD-10-CM code
Category
B20 Human immunodeficiency virus [HIV] disease
Chapter
1: Certain infectious and parasitic diseases (A00-B99)
CC/MCC (MS-DRG v44)
CC
CMS-HCC V28
HCC 1
POA reporting
Required

Tabular list notes for B20

Includes
  • acquired immune deficiency syndrome [AIDS]
  • AIDS-related complex [ARC]
  • HIV infection, symptomatic
Excludes1 (never coded together)
  • asymptomatic human immunodeficiency virus [HIV] infection status (Z21)
  • exposure to HIV virus (Z20.6)
  • inconclusive serologic evidence of HIV (R75)
Code first
  • Human immunodeficiency virus [HIV] disease complicating pregnancy, childbirth and the puerperium, if applicable (O98.7-)
Use additional code
  • code(s) to identify all manifestations of HIV infection

MS-DRG grouping when B20 is the principal diagnosis

MS-DRG v44 groups for B20 as principal diagnosis
MDCMS-DRGs
25 MDC 25: Human Immunodeficiency Virus Infections969970971972973974975976977

The final group also depends on procedures, secondary diagnoses and discharge status; the MS-DRG lookup for B20 shows the full grouping logic.

CC/MCC status and inpatient edits

As a secondary diagnosis, B20 is a CC under MS-DRG v44, unless the principal diagnosis is one of the 5 codes in its exclusion list. Check B20 against a principal diagnosis.

  • Present on admission: a POA indicator is required on inpatient claims.

CMS-HCC V28 risk adjustment

In the PY2027 mapping, B20 maps to HCC 1 (HIV/AIDS). The HCC lookup shows the RAF weight and the hierarchy.

LCD billing and coding articles that list B20

43 current Medicare billing and coding articles list B20 among the diagnoses that support medical necessity for the services they cover.

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Frequently asked questions

What does ICD-10-CM B20 mean?

B20 means human immunodeficiency virus [HIV] disease. It is one of 1 billable codes under B20, human immunodeficiency virus [HIV] disease.

What can't be coded with B20?

Excludes1 at B20: asymptomatic human immunodeficiency virus [HIV] infection status (Z21); exposure to HIV virus (Z20.6); inconclusive serologic evidence of HIV (R75). These are never reported together with B20.

What else is coded with B20?

The tabular instructions at B20: Human immunodeficiency virus [HIV] disease complicating pregnancy, childbirth and the puerperium, if applicable (O98.7-); code(s) to identify all manifestations of HIV infection.

Which MS-DRG does B20 group to?

As the principal diagnosis, B20 groups to MS-DRG 969 HIV with Extensive O.R. Procedures with MCC, MS-DRG 970 HIV with Extensive O.R. Procedures without MCC, MS-DRG 971 (MDC 25 MDC 25: Human Immunodeficiency Virus Infections) under MS-DRG v44, before procedures and secondary diagnoses are applied.

Does B20 map to an HCC?

Yes: HCC 1, HIV/AIDS, in the PY2027 CMS-HCC V28 mapping.

Is B20 a CC or MCC?

B20 is a CC under MS-DRG v44; 5 principal diagnoses exclude it.

Sources

Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-10. Verify against the primary file before billing or contracting decisions. The reference methodology explains how each figure is computed from these files.

Disclaimer

The descriptor and notes are reproduced from the FY2027 ICD-10-CM files; MS-DRG, CC/MCC and HCC facts come from the CMS FY2027 and PY2027 tables. Code from the medical record and the ICD-10-CM Official Guidelines. Not legal, clinical or billing advice.

Found a figure that does not match the CMS file? Report a data correction with the CMS file and the value you expected; the request reaches the editorial team through the contact form.