B19.20

Billable

Unspecified viral hepatitis C without hepatic coma

HCC Category Mapping

RxHCCHCC 55 — Acute Viral Hepatitis C

0.000

What This Code Means

A viral infection of the liver caused by hepatitis C virus where the specific subtype is unknown, without severe liver failure complications.

Coding Tips

•Use this code when hepatitis C is suspected or confirmed but hepatic coma is not present
•If acute or chronic hepatitis C status is documented, consider using more specific B17.1 or B18.2 codes

Clinical Significance

Unspecified viral hepatitis C without hepatic coma is used when a patient has hepatitis C but the documentation does not clarify whether the infection is acute or chronic. This code should prompt a provider query to determine chronicity, as chronic hepatitis C (B18.2) carries significantly higher risk adjustment value.

Documentation Requirements

✓Positive hepatitis C testing (anti-HCV antibody and/or HCV RNA)
✓Documentation of hepatitis C diagnosis without acute or chronic specification
✓Absence of hepatic coma/encephalopathy documented
✓Liver function tests
✓Query documentation for acute vs. chronic determination

Commonly Confused Codes

B18.2 (Chronic viral hepatitis C) — If chronic status is documented, use this more specific code which carries higher HCC value B17.10 (Acute hepatitis C without hepatic coma) — If acute status is documented, use this code B19.21 (Unspecified viral hepatitis C with hepatic coma) — Same unspecified hepatitis C but with hepatic coma present

Code Hierarchy

└B19Unspecified viral hepatitis └B19.2Unspecified viral hepatitis C └B19.20Unspecified viral hepatitis C without hepatic coma

└B19.20Unspecified viral hepatitis C without hepatic coma