B33.0 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · HCC coding software

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Code lookupB33.0

Effective periodFY2026 Apr Update (Apr 1-Sep 30)

FY 2026 Apr update / Certain infectious and parasitic diseases (A00-B99) / Other viral diseases (B25-B34)

B33.0

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

Epidemic myalgia

Epidemic myalgia is a viral infection that causes sudden onset of severe muscle pain and inflammation, typically affecting the chest, abdomen, or limbs. It spreads through communities and is often caused by enteroviruses like coxsackievirus B.

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

N/A

—

Not risk-adjusted for this model/period.

Not mapped

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

B33Other viral diseases, not elsewhere classified B33.0Epidemic myalgia

Inclusion Terms

Official

Bornholm disease

Excludes 2

Official

carrier or suspected carrier of infectious disease (Z22.-)Inherited from A00-B99
infectious and parasitic diseases complicating pregnancy, childbirth and the puerperium (O98.-)Inherited from A00-B99
infectious and parasitic diseases specific to the perinatal period (P35-P39)Inherited from A00-B99
influenza and other acute respiratory infections (J00-J22)Inherited from A00-B99

Related Codes

Official

B33.1Ross River disease B33.2Viral carditis B33.3Retrovirus infections, not elsewhere classified B33.4Hantavirus (cardio)-pulmonary syndrome [HPS] [HCPS]B33.8Other specified viral diseases

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

Code First

Official

No Code First sequencing instructions are included in this display for B33.0. 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 B33.0. Check the code and parent instructions in the Code Book.

Buddy Documentation Tip

HCC Buddy guidance

Verify the specific causative virus if documented, as some enterovirus codes may provide more specificity than B33.0

Ensure the condition is documented as epidemic or occurring in an outbreak context to distinguish from other myalgia diagnoses

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 B33.0 an HCC code?

No. B33.0 is a billable ICD-10-CM code with no mapping under the current CMS-HCC V28 community payment model, and none under the ESRD, Part D RxHCC, or HHS-HCC models.

Code: B33.0
Description: Epidemic myalgia
HCC (V28): No CMS-HCC V28 mapping
RAF reference coefficient: —
Billable: Yes
Payment year: 2026

Coder workflow notes

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What This Code Means

B33.0 is the ICD-10-CM diagnosis code for epidemic myalgia. Epidemic myalgia is a viral infection that causes sudden onset of severe muscle pain and inflammation, typically affecting the chest, abdomen, or limbs. It spreads through communities and is often caused by enteroviruses like coxsackievirus B. B33.0 sits in the ICD-10-CM chapter for certain infectious and parasitic diseases (a00-b99), within the section covering other viral diseases (b25-b34).

B33.0 is a billable ICD-10-CM code, but no current CMS-HCC V28 community payment mapping is shown, and none under the ESRD, Part D RxHCC, or HHS-HCC models. Do not assign risk adjustment value from this page when no source-backed mapping is shown; verify the applicable model and payment year.

Verify the specific causative virus if documented, as some enterovirus codes may provide more specificity than B33.0.

HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for B33.0 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Verify the specific causative virus if documented, as some enterovirus codes may provide more specificity than B33.0
•Ensure the condition is documented as epidemic or occurring in an outbreak context to distinguish from other myalgia diagnoses