Question 1

What is ICD-10 code A60.1?

Accepted Answer

A60.1 is the ICD-10-CM diagnosis code for Herpesviral infection of perianal skin and rectum. It belongs to the ICD-10-CM chapter for certain infectious and parasitic diseases (a00-b99). A60.1 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. A60.1 is part of the FY2026 ICD-10-CM code set published by the CMS National Center for Health Statistics and used on Medicare, Medicaid, and commercial claims in the United States.

Question 2

Is A60.1 an HCC code?

Accepted Answer

A60.1 has no payable CMS-HCC V28 mapping in the final FY2026 CMS file.

Question 3

Is A60.1 billable?

Accepted Answer

Yes. A60.1 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. A60.1 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

Question 4

Which HCC does A60.1 map to under V28?

Accepted Answer

A60.1 has no payable CMS-HCC V28 mapping in the final FY2026 CMS file.

Question 5

What RAF reference is published for A60.1?

Accepted Answer

A60.1 has no V28 reference coefficient because the final FY2026 source verifies no payable V28 mapping.

Question 6

What is the V28 vs V24 difference for A60.1?

Accepted Answer

A60.1 has verified no payable V28 mapping in the final FY2026 source. Select a historical effective period before making any V24 comparison.

Question 7

What documentation supports A60.1?

Accepted Answer

Verify documentation specifies herpesviral infection of perianal skin and/or rectum; do not use this code for other herpes locations without proper documentation This code may be used with additional codes to identify the type of herpes simplex virus (HSV-1 or HSV-2) if documented, and consider adding codes for any complications such as secondary bacterial infection A60.1 is not a CMS-HCC V28 payment code in the verified current source, so MEAT is not the payment hook. Documentation still has to support the diagnosis if you report it.

Question 8

Can A60.1 be a primary diagnosis?

Accepted Answer

Yes. A60.1 carries no code-first instruction in the FY2026 tabular, so it can be the first-listed diagnosis when it is the condition chiefly responsible for the encounter and the note supports it, and it can also be reported as a secondary diagnosis. For risk adjustment the order does not matter; the V28 category is the same either way.

Question 9

Which codes cannot be reported with A60.1?

Accepted Answer

The Excludes1 note that applies to A60.1 lists certain localized infections - see body system-related chapters; nonspecific and nongonococcal urethritis (N34.1); Reiter's disease (M02.3-). An Excludes1 condition is not reported together with A60.1; report one or the other, unless the two conditions are unrelated, which the ICD-10-CM Official Guidelines (Section I.A.12.a) allow. The Excludes2 note lists carrier or suspected carrier of infectious disease (Z22.-); infectious and parasitic diseases complicating pregnancy, childbirth and the puerperium (O98.-); infectious and parasitic diseases specific to the perinatal period (P35-P39); influenza and other acute respiratory infections (J00-J22); and 1 more (see the notes on this page); those are separate conditions that may be reported together with A60.1 when both are documented.

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A60.1

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A60.1 ICD-10-CM Code: Herpesviral infection of perianal skin and rectum

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A60.1

Is A60.1 an HCC code?

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