B18.0

Billable

Chronic viral hepatitis B with delta-agent

HCC Category Mapping

V28HCC 65 — Chronic Hepatitis

0.472

V24HCC 29 — Chronic Hepatitis

0.245

ESRDHCC 29 — Chronic Hepatitis

0.000

RxHCCHCC 56 — Chronic Viral Hepatitis B and Other

0.000

What This Code Means

A long-term hepatitis B infection in which the patient also carries the delta virus, causing ongoing liver inflammation.

Coding Tips

•This code indicates both chronic hepatitis B and delta coinfection
•Distinguish from B18.1 (hepatitis B without delta) and B17.0 (acute delta superinfection)

Clinical Significance

Chronic hepatitis B with delta-agent coinfection represents dual infection with both hepatitis B virus and hepatitis D virus, which is the most severe form of chronic viral hepatitis. Delta virus requires hepatitis B surface antigen for replication, making this a dependent coinfection that accelerates progression to cirrhosis and liver failure.

Documentation Requirements

✓Positive hepatitis B surface antigen (HBsAg) confirming chronic hepatitis B carrier status
✓Positive hepatitis D (delta) virus antibody (anti-HDV) or HDV RNA confirming coinfection
✓Duration of infection documented (chronic = >6 months)
✓Liver disease staging: fibrosis score (METAVIR, FIB-4), imaging findings, or biopsy results
✓Current antiviral treatment regimen and viral load monitoring

Commonly Confused Codes

B18.1 (Chronic viral hepatitis B without delta-agent) — Hepatitis B alone without delta virus coinfection; different prognosis and treatment approach B17.0 (Acute delta-(super)infection of hepatitis B carrier) — Acute delta infection in an existing hepatitis B carrier; B18.0 is for chronic coinfection B18.2 (Chronic viral hepatitis C) — Different virus entirely; hepatitis C does not require hepatitis B for replication

Code Hierarchy

└B18Chronic viral hepatitis └B18.0Chronic viral hepatitis B with delta-agent

└B18.0Chronic viral hepatitis B with delta-agent