ICD-10-CM Code For Human Immunodeficiency Virus Disease: Group Overview

The International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) code group B20 includes diagnoses for confirmed human immunodeficiency virus infection with associated clinical manifestations and opportunistic infections, as well as HIV-related conditions affecting multiple organ systems. These ICD-10-CM diagnosis codes are used to document patient encounters where HIV disease severity, organ system involvement, and related complications need to be captured for clinical records and claims. Accurate coding within the ICD-10-CM B20 group supports proper claim adjudication.

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ICD-10-CM B20: Human Immunodeficiency Virus [HIV] Disease Overview

The diagnoses in this group represent confirmed human immunodeficiency virus infection with associated clinical manifestations and complications affecting multiple organ systems. They target immune system dysfunction due to HIV and any resulting opportunistic infections or HIV-related conditions. Accurate coding matters for complete clinical documentation and appropriate claim adjudication.

When to Use

Use a code from this group when a medical record documents confirmed human immunodeficiency virus disease with specific manifestations or complications requiring clinical or billing documentation. These codes are applied for encounters where HIV infection directly influences diagnosis, treatment decisions, or resource use.

ICD-10-CM Codes

1 rows

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

DRG Codes

6 rows

DRG Code	Description
969	HIV with Extensive O.R. Procedures with MCC
970	HIV with Extensive O.R. Procedures without MCC
974	HIV with Major Related Condition with MCC
975	HIV with Major Related Condition with CC
976	HIV with Major Related Condition without CC/MCC
977	HIV with or without Other Related Condition

Typical Clinical Scenarios

A 32-year-old person with known HIV presents to the clinic for routine HIV management with complaints of fatigue and a recent opportunistic infection (oral candidiasis). Laboratory testing shows detectable HIV viral load and declining CD4 count, and the encounter documents ongoing symptomatic HIV infection; a diagnosis from this group is assigned to indicate active HIV disease under care. Typical codes: B20
A 45-year-old patient arrives at the emergency department with fever, progressive weight loss, and shortness of breath; chest imaging and sputum studies confirm Pneumocystis jirovecii pneumonia, and HIV testing returns positive. Because the acute severe opportunistic infection occurs in the setting of HIV, a code from this group is used to capture HIV disease complicated by an AIDS‑defining illness. Typical codes: B20
A 28-year-old pregnant person with previously diagnosed HIV presents for prenatal care; antiretroviral therapy is documented and additional counseling and coordination of care are provided to reduce vertical transmission risk. The visit is coded to reflect the patient’s HIV disease status affecting pregnancy management. Typical codes: B20

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

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When to Use

ICD-10-CM Codes

1 rows

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

DRG Codes

6 rows

DRG Code	Description
969	HIV with Extensive O.R. Procedures with MCC
970	HIV with Extensive O.R. Procedures without MCC
974	HIV with Major Related Condition with MCC
975	HIV with Major Related Condition with CC
976	HIV with Major Related Condition without CC/MCC
977	HIV with or without Other Related Condition

Typical Clinical Scenarios

A 32-year-old person with known HIV presents to the clinic for routine HIV management with complaints of fatigue and a recent opportunistic infection (oral candidiasis). Laboratory testing shows detectable HIV viral load and declining CD4 count, and the encounter documents ongoing symptomatic HIV infection; a diagnosis from this group is assigned to indicate active HIV disease under care. Typical codes: B20
A 45-year-old patient arrives at the emergency department with fever, progressive weight loss, and shortness of breath; chest imaging and sputum studies confirm Pneumocystis jirovecii pneumonia, and HIV testing returns positive. Because the acute severe opportunistic infection occurs in the setting of HIV, a code from this group is used to capture HIV disease complicated by an AIDS‑defining illness. Typical codes: B20
A 28-year-old pregnant person with previously diagnosed HIV presents for prenatal care; antiretroviral therapy is documented and additional counseling and coordination of care are provided to reduce vertical transmission risk. The visit is coded to reflect the patient’s HIV disease status affecting pregnancy management. Typical codes: B20

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

ICD-10-CM Code For Human Immunodeficiency Virus Disease: Group Overview

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ICD-10-CM B20: Human Immunodeficiency Virus [HIV] Disease Overview

ICD-10-CM Code For Human Immunodeficiency Virus Disease: Group Overview

Sign up for ICD-10-CM Code For Human Immunodeficiency Virus Disease: Group Overview policy alerts

ICD-10-CM B20: Human Immunodeficiency Virus [HIV] Disease Overview

When to Use

ICD-10-CM Codes

DRG Codes

Typical Clinical Scenarios

What diagnosis does ICD-10-CM code `B20` represent?

When should `B20` be used in clinical documentation and claims?

How does coding `B20` affect claim adjudication?

What types of complications are included under the `B20` group?

Which DRG categories are related to `B20` for reimbursement grouping?

References

When to Use

ICD-10-CM Codes

DRG Codes

Typical Clinical Scenarios

What diagnosis does ICD-10-CM code `B20` represent?

When should `B20` be used in clinical documentation and claims?

How does coding `B20` affect claim adjudication?

What types of complications are included under the `B20` group?

Which DRG categories are related to `B20` for reimbursement grouping?

References