B97.11 ICD-10-CM Code: Coxsackievirus as the cause of diseases classified elsewhere
HCC Buddy Code Card
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FY 2026 Apr update / Certain infectious and parasitic diseases (A00-B99) / Bacterial and viral infectious agents (B95-B97)
B97.11
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceCoxsackievirus as the cause of diseases classified elsewhere
Coxsackievirus, a type of enterovirus, is identified as the causative agent of a disease classified elsewhere. These viruses commonly cause respiratory and gastrointestinal infections.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
N/A—
Not mapped
ACA/HHS
N/A—
Not mapped
ESRD/PACE
N/A—
Not mapped
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for B97.11 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for B97.11 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for B97.11 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for B97.11 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for B97.11 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for B97.11 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for B97.11 in this effective period.
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 B97.11 an HCC code?
No. B97.11 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
- Code
- B97.11
- Description
- Coxsackievirus as the cause of diseases classified elsewhere
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF
- —
- 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
B97.11 is the ICD-10-CM diagnosis code for coxsackievirus as the cause of diseases classified elsewhere. Coxsackievirus, a type of enterovirus, is identified as the causative agent of a disease classified elsewhere. These viruses commonly cause respiratory and gastrointestinal infections. B97.11 sits in the ICD-10-CM chapter for certain infectious and parasitic diseases (a00-b99), within the section covering bacterial and viral infectious agents (b95-b97).
B97.11 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.
Use as a secondary diagnosis code after coding the primary manifestation of the infection.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for B97.11 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Use as a secondary diagnosis code after coding the primary manifestation of the infection
- •Associated with hand-foot-and-mouth disease, myocarditis, and meningitis