B18.2 ICD-10-CM Code: Chronic viral hepatitis C
B18.2 maps to CMS-HCC V28 65. A source-labeled RAF reference is available. Confirm the documented diagnosis and applicable coding requirements. MEAT criteria · RAF Calculator · HCC Buddy coding tools
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FY 2026 Apr update / Certain infectious and parasitic diseases (A00-B99) / Viral hepatitis (B15-B19)
B18.2
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceChronic viral hepatitis C
A long-term hepatitis C infection where the virus persists in the body and can cause ongoing liver damage.
Buddy Insight
Chronic viral hepatitis C is one of the most commonly coded chronic viral infections in risk adjustment, affecting approximately 2.
CMS-HCC V28
MappedHCC 65
Coefficient HCC 65: 0.185 (Community Non-Dual Aged (CNA))
CMS-HCC V24
HistoricalHistorical
Not used for CY2026 payment
ACA/HHS
MappedHCC 037_1
Code-level coefficient reference
ESRD/PACE
MappedHCC 29
Code-level coefficient reference
RXHCC
MappedHCC 54
Code-level coefficient reference
Code Book Path
Inclusion Terms
Official- Carrier of viral hepatitis C
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
Includes
Official- diseases generally recognized as communicable or transmissibleInherited from A00-B99, B18
- Carrier of viral hepatitisInherited from A00-B99, B18
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
OfficialNo Code First sequencing instructions are included in this display for B18.2. 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, B18
- code, if applicable, for ascites (R18.8)Inherited from A00-B99, B18
Code Also
OfficialNo Code Also instructions are included in this display for B18.2. Check the code and parent instructions in the Code Book.
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
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 B18.2 an HCC code?
Yes. B18.2 (Chronic viral hepatitis C) maps to HCC 65, Chronic Hepatitis under the CMS-HCC V28 risk adjustment model, with a source-labeled community non-dual aged reference coefficient of 0.185. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes. It is billable for payment year 2026.
Coder answer: B18.2 is billable and maps to V28 HCC 65, Chronic Hepatitis. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.
- Code
- B18.2
- Description
- Chronic viral hepatitis C
- HCC (V28)
- HCC 65 — Chronic Hepatitis
- RAF reference coefficient
- 0.185
- Billable
- Yes
- Payment year
- 2026
HCC Category Mapping
These are source-labeled model coefficients, not member totals. A category may still be removed by hierarchy or model cleanup rules. Weights are not directly comparable across models: CMS-HCC V28 and V24 use Community, Non-Dual, Aged; ESRD uses the dialysis continuing-enrollee model; RxHCC is the Part D continuing-enrollee, non-low-income, aged weight (a larger scale than CMS-HCC). ACA/HHS has no single weight — it varies by metal level. Actual per-patient RAF contribution depends on member context, hierarchy and cleanup rules, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains available for historical review.
Work B18.2 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →
MEAT review for B18.2
For B18.2, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule.
- MMonitor: signs, symptoms, disease progression, or lab trending documented in the note
- EEvaluate: test results, medication response, or physical findings reviewed by the provider
- AAssess: explicit mention in the assessment or plan with acknowledgment of status
- TTreat: medication, referral, procedure, therapy, or counseling tied to the diagnosis
Coder workflow notes
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What This Code Means
B18.2 is the ICD-10-CM diagnosis code for chronic viral hepatitis c. A long-term hepatitis C infection where the virus persists in the body and can cause ongoing liver damage. B18.2 sits in the ICD-10-CM chapter for certain infectious and parasitic diseases (a00-b99), within the section covering viral hepatitis (b15-b19).
Under the CMS-HCC V28 risk adjustment model, B18.2 maps to Chronic Hepatitis (HCC 65) with a source-labeled community, non-dual, aged reference coefficient of 0.185. For CY2026 non-PACE Medicare Advantage, CMS uses 100% of the 2024 CMS-HCC model (V28). PACE uses a separate model blend. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes.
Chronic viral hepatitis C, chronic HCV infection established by RNA positivity > 6 months or a provider diagnosis of chronic hepatitis C. Query for cirrhosis (K74.6x) or hepatocellular carcinoma (C22.0) when applicable. For B18.2, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule. When documentation is ambiguous, coders should issue a provider query rather than assume the highest-specificity variant.
HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for B18.2 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Chronic viral hepatitis C, chronic HCV infection established by RNA positivity > 6 months or a provider diagnosis of chronic hepatitis C. Query for cirrhosis (K74.6x) or hepatocellular carcinoma (C22.0) when applicable.
- •Do not use B18.2 when the patient has achieved sustained virologic response (SVR) after DAA therapy, use Z86.19 for resolved HCV history.
- •Chronic HCV is a commonly missed HCC because SVR vs chronic status requires lab and chart review.
Clinical Significance
Chronic viral hepatitis C is one of the most commonly coded chronic viral infections in risk adjustment, affecting approximately 2.4 million Americans. It is a leading cause of cirrhosis, hepatocellular carcinoma, and liver transplantation. Accurate capture is critical for both risk adjustment and ensuring patients receive curative direct-acting antiviral therapy.
Documentation Requirements
- ✓Positive hepatitis C antibody (anti-HCV) AND detectable HCV RNA confirming active chronic infection
- ✓Duration >6 months or documentation of chronic status by provider
- ✓HCV genotype documented (affects treatment selection)
- ✓Liver disease staging: fibrosis assessment (FIB-4, elastography, or biopsy), cirrhosis status
- ✓Treatment history: prior treatment attempts, current DAA therapy, sustained virologic response (SVR) status
Commonly Confused Codes
- •B17.10 (Acute hepatitis C without hepatic coma): Newly acquired infection; chronic implies >6 months duration
- •B19.20 (Unspecified viral hepatitis C without hepatic coma): Use when acute vs. chronic is unknown; B18.2 requires confirmed chronicity
- •Z22.52 (Carrier of viral hepatitis C): Carrier status; B18.2 is active chronic infection with detectable viral load
- •B18.1 (Chronic viral hepatitis B without delta): Different hepatitis virus; verify which hepatitis type is documented