What is ICD-10 code B16.0?

B16.0 is the ICD-10-CM diagnosis code for Acute hepatitis B with delta-agent with hepatic coma. It belongs to the ICD-10-CM chapter for certain infectious and parasitic diseases (a00-b99). B16.0 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. B16.0 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.

Yes. B16.0 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. B16.0 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.

Which HCC does B16.0 map to under V28?

B16.0 has no payable CMS-HCC V28 mapping in the final FY2026 CMS file.

What RAF reference is published for B16.0?

B16.0 has no V28 reference coefficient because the final FY2026 source verifies no payable V28 mapping.

What is the V28 vs V24 difference for B16.0?

B16.0 has verified no payable V28 mapping in the final FY2026 source. Select a historical effective period before making any V24 comparison.

2026 ICD-10-CM B16.0: Acute hepatitis B with delta-agent

B16.0 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · free HCC coding tools

ICD-10-CM Code View

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Code lookupB16.0

Effective periodFY2026 Apr Update (Apr 1-Sep 30)

FY 2026 Apr update / Certain infectious and parasitic diseases (A00-B99) / Viral hepatitis (B15-B19)

B16.0

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Acute hepatitis B with delta-agent with hepatic coma

This is a severe acute infection of the liver caused by both hepatitis B and delta viruses occurring together, where the patient has developed hepatic coma (a serious condition where liver failure causes loss of consciousness). This is a life-threatening condition requiring immediate medical intervention.

Overview Risk Models Code Book Documentation Audit Notes Edition comparison

CMS-HCC V28

N/A

—

Not risk-adjusted for this model/period.

Not mapped

CMS-HCC V24

Historical

Not used for standard CY2026 Medicare Advantage payment. Select a historical period to review V24.

Not used for CY2026 payment

ACA/HHS

Mapped

HCC 035_1

HHS-HCC 035_1 adult, RAF vari...

Code-level coefficient reference

ESRD/PACE

N/A

—

Not risk-adjusted for this model/period.

Not mapped

RXHCC

N/A

—

Not risk-adjusted for this model/period.

Not mapped

Code Book Path

Official

B16Acute hepatitis B B16.0Acute hepatitis B with delta-agent with hepatic coma

Inclusion Terms

Official

No inclusion terms are included in this display for B16.0. Check the code and parent instructions in the Code Book.

Excludes 2

Official

carrier or suspected carrier of infectious disease (Z22.-)Inherited from A00-B99, B15-B19
infectious and parasitic diseases complicating pregnancy, childbirth and the puerperium (O98.-)Inherited from A00-B99, B15-B19
infectious and parasitic diseases specific to the perinatal period (P35-P39)Inherited from A00-B99, B15-B19
influenza and other acute respiratory infections (J00-J22)Inherited from A00-B99, B15-B19
cytomegaloviral hepatitis (B25.1)Inherited from A00-B99, B15-B19
herpesviral [herpes simplex] hepatitis (B00.81)Inherited from A00-B99, B15-B19

Related Codes

Official

B16.1Acute hepatitis B with delta-agent without hepatic coma B16.2Acute hepatitis B without delta-agent with hepatic coma B16.9Acute hepatitis B without delta-agent and without hepatic coma

Includes

Official

diseases generally recognized as communicable or transmissibleInherited from A00-B99

Excludes 1

Official

certain localized infections - see body system-related chaptersInherited from A00-B99, B15-B19
sequelae of viral hepatitis (B94.2)Inherited from A00-B99, B15-B19

Code First

Official

No Code First sequencing instructions are included in this display for B16.0. Check the code and parent instructions in the Code Book.

Use Additional

Official

code to identify resistance to antimicrobial drugs (Z16.-)Inherited from A00-B99

Code Also

Official

No Code Also instructions are included in this display for B16.0. Check the code and parent instructions in the Code Book.

Buddy Documentation Tip

HCC Buddy guidance

This code should only be used when both hepatitis B and delta-agent (hepatitis D) are confirmed present with documented hepatic coma; do not use if coma is absent

Verify documentation clearly states 'acute' hepatitis B with delta-agent and hepatic coma, as chronic variants and cases without coma require different codes

Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →

Is B16.0 an HCC code?

B16.0 is not in the CMS-HCC V28 or V24 community payment model. B16.0 also appears in the HHS-HCC commercial risk model (HCC 035_1 (HHS-HCC 035_1 adult, RAF varies by metal level)), which is a commercial market model rather than a Medicare Advantage payment mapping.

Code: B16.0
Description: Acute hepatitis B with delta-agent with hepatic coma
HCC (V28): No CMS-HCC V28 mapping
RAF reference coefficient: —
Billable: Yes
Payment year: 2026

Coder workflow notes

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This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).

What This Code Means

B16.0 is the ICD-10-CM diagnosis code for acute hepatitis b with delta-agent with hepatic coma. This is a severe acute infection of the liver caused by both hepatitis B and delta viruses occurring together, where the patient has developed hepatic coma (a serious condition where liver failure causes loss of consciousness). This is a life-threatening condition requiring immediate medical intervention. B16.0 sits in the ICD-10-CM chapter for certain infectious and parasitic diseases (a00-b99), within the section covering viral hepatitis (b15-b19).

B16.0 has no mapping under the CMS-HCC V28 or V24 community payment models. B16.0 also appears in the HHS-HCC commercial risk model (HCC 035_1 (HHS-HCC 035_1 adult, RAF varies by metal level)), which is a commercial market model rather than a Medicare Advantage payment mapping. Do not assign V28 risk adjustment value from this page; verify the applicable model and payment year before using this code for risk adjustment.

This code should only be used when both hepatitis B and delta-agent (hepatitis D) are confirmed present with documented hepatic coma; do not use if coma is absent.

HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for B16.0 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•This code should only be used when both hepatitis B and delta-agent (hepatitis D) are confirmed present with documented hepatic coma; do not use if coma is absent
•Verify documentation clearly states 'acute' hepatitis B with delta-agent and hepatic coma, as chronic variants and cases without coma require different codes