B34.1 ICD-10-CM Code: Enterovirus infection, unspecified
HCC Buddy Code Card
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FY 2026 Apr update / Certain infectious and parasitic diseases (A00-B99) / Other viral diseases (B25-B34)
B34.1
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceEnterovirus infection, unspecified
Enterovirus infection is a viral illness caused by enteroviruses that can cause respiratory symptoms, gastrointestinal symptoms, or other systemic manifestations.
CMS-HCC V28
00
RAF 0
CMS-HCC V24
00
RAF 0
ACA/HHS
00
RAF 0
ESRD/PACE
00
RAF 0
RXHCC
00
RAF 0
Code Trumping
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Code Book Path
Inclusion Terms
Official- Coxsackievirus infection NOS
- Echovirus infection NOS
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for B34.1 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for B34.1 in this effective period.
Excludes 1
Official- anogenital human papillomavirus infection (A63.0)
- cytomegaloviral disease NOS (B25.9)
- herpesvirus [herpes simplex] infection NOS (B00.9)
- retrovirus infection NOS (B33.3)
- viral agents as the cause of diseases classified elsewhere (B97.-)
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for B34.1 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for B34.1 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for B34.1 in this effective period.
Buddy Documentation Tip
Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.
Is B34.1 an HCC code?
No. B34.1 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
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
B34.1 is the ICD-10-CM diagnosis code for enterovirus infection, unspecified. Enterovirus infection is a viral illness caused by enteroviruses that can cause respiratory symptoms, gastrointestinal symptoms, or other systemic manifestations. B34.1 sits in the ICD-10-CM chapter for certain infectious and parasitic diseases (a00-b99), within the section covering other viral diseases (b25-b34).
B34.1 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.
Specify the type of enterovirus (e.g., coxsackievirus, echovirus) if identified for more precise coding.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for B34.1 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Specify the type of enterovirus (e.g., coxsackievirus, echovirus) if identified for more precise coding
- •Document the primary site of infection and any complications such as meningitis or myocarditis