B19.0 ICD-10-CM Code: Unspecified viral hepatitis with hepatic coma
B19.0 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · free HCC coding tools
HCC Buddy Code Card
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FY 2026 Apr update / Certain infectious and parasitic diseases (A00-B99) / Viral hepatitis (B15-B19)
B19.0
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceUnspecified viral hepatitis with hepatic coma
A serious viral infection of the liver that has progressed to cause hepatic coma, a life-threatening condition where the liver fails and affects brain function.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
HistoricalHistorical
Not used for CY2026 payment
ACA/HHS
MappedHCC 035_1
Code-level coefficient reference
ESRD/PACE
N/A—
Not mapped
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
OfficialNo inclusion terms are included in this display for B19.0. 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
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
OfficialNo Code First sequencing instructions are included in this display for B19.0. 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
OfficialNo Code Also instructions are included in this display for B19.0. Check the code and parent instructions in the Code Book.
Buddy Documentation Tip
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 B19.0 an HCC code?
B19.0 is not in the CMS-HCC V28 or V24 community payment model. B19.0 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
- B19.0
- Description
- Unspecified viral hepatitis 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
B19.0 is the ICD-10-CM diagnosis code for unspecified viral hepatitis with hepatic coma. A serious viral infection of the liver that has progressed to cause hepatic coma, a life-threatening condition where the liver fails and affects brain function. B19.0 sits in the ICD-10-CM chapter for certain infectious and parasitic diseases (a00-b99), within the section covering viral hepatitis (b15-b19).
B19.0 has no mapping under the CMS-HCC V28 or V24 community payment models. B19.0 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 indicates severe hepatitis with complications; ensure documentation specifies hepatic coma is present.
HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for B19.0 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This code indicates severe hepatitis with complications; ensure documentation specifies hepatic coma is present
- •Do not use this code if the specific type of viral hepatitis (A, B, C, D, or E) is identified; use the more specific code instead