What is ICD-10 code B97.35?

B97.35 is the ICD-10-CM diagnosis code for Human immunodeficiency virus, type 2 [HIV 2] as the cause of diseases classified elsewhere. Human immunodeficiency virus type 2 (HIV-2) is identified as the underlying cause of another disease or condition being treated. B97.35 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. B97.35 is part of the FY2026 ICD-10-CM code set published by the CMS National Center for Health Statistics and used on Medicare, Medicaid, and commercial claims in the United States.

Yes. B97.35 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. B97.35 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

Which HCC does B97.35 map to under V28?

B97.35 maps to CMS-HCC V28 HCC 1 (HIV/AIDS). The category numbers, labels, and conditions come from the CMS-HCC V28 model file for payment year 2026.

What documentation supports B97.35?

Human immunodeficiency virus, type 2 (HIV 2) as the cause of diseases classified elsewhere, used when HIV-2 specifically is the causative organism for another documented condition. Distinguish HIV-1 (the predominant strain) from HIV-2 (rarer, geographically concentrated). Lab typing must support the HIV-2 designation. B97.35 maps to V28 HCC 1 (HIV/AIDS) at RAF 0.301, the same HCC as B20. When HIV-2 is documented as the cause of another condition, the B97.35 code itself captures the HIV HCC. For B97.35, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule. See the MEAT criteria checklist at /meat-criteria for what Monitor, Evaluate, Assess, or Treat looks like in a note. One mnemonic element does not establish that a diagnosis is reportable.

2026 ICD-10-CM B97.35: Human immunodeficiency virus

B97.35 maps to CMS-HCC V28 1. A source-labeled RAF reference is available. Confirm the documented diagnosis and applicable coding requirements. MEAT criteria · RAF Calculator · HCC coding software

ICD-10-CM Code View

HCC Buddy Code Card

Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.

Code lookupB97.35

Effective periodFY2026 Apr Update (Apr 1-Sep 30)

FY 2026 Apr update / Certain infectious and parasitic diseases (A00-B99) / Bacterial and viral infectious agents (B95-B97)

B97.35

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

Human immunodeficiency virus, type 2 [HIV 2] as the cause of diseases classified elsewhere

Human immunodeficiency virus type 2 (HIV-2) is identified as the underlying cause of another disease or condition being treated.

Buddy Insight

HIV-2 as cause of disease classified elsewhere identifies the specific viral strain when HIV-2 is the underlying etiology.

Overview Risk Models Code Book Documentation Audit Notes Edition comparison

CMS-HCC V28

Mapped

HCC 1

HIV/AIDS

Code-level coefficient reference

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

Mapped

HCC 001

HHS-HCC 001 adult, RAF varies...

Code-level coefficient reference

ESRD/PACE

Mapped

HCC 1

HIV/AIDS

Code-level coefficient reference

RXHCC

Mapped

HCC 1

HIV/AIDS

Code-level coefficient reference

Code Book Path

Official

B97Viral agents as the cause of diseases classified elsewhere B97.3Retrovirus as the cause of diseases classified elsewhere B97.35Human immunodeficiency virus, type 2 [HIV 2] as the cause of diseases classified elsewhere

Inclusion Terms

Official

No inclusion terms are included in this display for B97.35. 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
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

B97.30Unspecified retrovirus as the cause of diseases classified elsewhere B97.31Lentivirus as the cause of diseases classified elsewhere B97.32Oncovirus as the cause of diseases classified elsewhere B97.33Human T-cell lymphotrophic virus, type I [HTLV-I] as the cause of diseases classified elsewhere B97.34Human T-cell lymphotrophic virus, type II [HTLV-II] as the cause of diseases classified elsewhere

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, B97.3
Human immunodeficiency virus [HIV] disease (B20)Inherited from A00-B99, B97.3

Code First

Official

No Code First sequencing instructions are included in this display for B97.35. 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 B97.35. Check the code and parent instructions in the Code Book.

Buddy Documentation Tip

HCC Buddy guidance

Confirmatory HIV-2 serologic testing (HIV-2 specific Western blot or differentiation assay)

Documentation that the infection is specifically HIV-2, not HIV-1 or dual infection

The primary manifestation/condition being caused by HIV-2 must also be coded

Current antiretroviral regimen documented (noting NNRTI resistance)

MEAT Support

HCC Buddy guidance

Confirmatory HIV-2 serologic testing (HIV-2 specific Western blot or differentiation assay)

Documentation that the infection is specifically HIV-2, not HIV-1 or dual infection

The primary manifestation/condition being caused by HIV-2 must also be coded

Current antiretroviral regimen documented (noting NNRTI resistance)

Audit Caution

HCC Buddy guidance

Using B97.35 as a standalone code — it is a supplementary code and must accompany the primary condition it is causing

Not distinguishing between HIV-1 and HIV-2 when serologic differentiation has been performed

Confusing this supplementary causative agent code with B20, which is the primary HIV disease code

Missing the clinical significance of HIV-2 strain identification for antiretroviral drug selection (NNRTI resistance)

Common Mistakes

HCC Buddy guidance

B20 (HIV disease resulting in infectious and parasitic diseases) - B20 is used for symptomatic HIV disease as the primary diagnosis; B97.35 is the supplementary causative agent code

Z21 (Asymptomatic HIV infection status) - use for asymptomatic HIV, not as a causative agent code

B97.33 (HIV-1 as the cause) - different strain; HIV-2 has different treatment implications and drug resistance

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 B97.35 an HCC code?

Yes. B97.35 (Human immunodeficiency virus, type 2 [HIV 2] as the cause of diseases classified elsewhere) maps to HCC 1, HIV/AIDS under the CMS-HCC V28 risk adjustment model, with a source-labeled community non-dual aged reference coefficient of 0.301. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes. It is billable for payment year 2026.

Coder answer: B97.35 is billable and maps to V28 HCC 1, HIV/AIDS. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.

Code: B97.35
Description: Human immunodeficiency virus, type 2 [HIV 2] as the cause of diseases classified elsewhere
HCC (V28): HCC 1 — HIV/AIDS
RAF reference coefficient: 0.301
Billable: Yes
Payment year: 2026

HCC Category Mapping

V28HCC 1, HIV/AIDS

0.301

ESRDHCC 1, HIV/AIDS

Not separately weighted

RxHCCHCC 1, HIV/AIDS

Not separately weighted

These are source-labeled model coefficients, not member totals. A category may still be removed by hierarchy or model cleanup rules. Weights are not directly comparable across models: CMS-HCC V28 and V24 use Community, Non-Dual, Aged; ESRD uses the dialysis continuing-enrollee model; RxHCC is the Part D continuing-enrollee, non-low-income, aged weight (a larger scale than CMS-HCC). ACA/HHS has no single weight — it varies by metal level. Actual per-patient RAF contribution depends on member context, hierarchy and cleanup rules, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains available for historical review.

Work B97.35 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT review for B97.35

For B97.35, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule.

MMonitor: signs, symptoms, disease progression, or lab trending documented in the note
EEvaluate: test results, medication response, or physical findings reviewed by the provider
AAssess: explicit mention in the assessment or plan with acknowledgment of status
TTreat: medication, referral, procedure, therapy, or counseling tied to the diagnosis

Coder workflow notes

Get the V28 mapping + MEAT cheat sheet

One printable reference: check representative V28 mappings and the documentation reminders your note needs. Free, no card.

Free PDF. No card. Unsubscribe anytime.

What This Code Means

B97.35 is the ICD-10-CM diagnosis code for human immunodeficiency virus, type 2 [hiv 2] as the cause of diseases classified elsewhere. Human immunodeficiency virus type 2 (HIV-2) is identified as the underlying cause of another disease or condition being treated. B97.35 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).

Under the CMS-HCC V28 risk adjustment model, B97.35 maps to HIV/AIDS (HCC 1) with a source-labeled community, non-dual, aged reference coefficient of 0.301. No V24 mapping is shown for B97.35; use the applicable model and payment year when reviewing the V28 mapping. For CY2026 non-PACE Medicare Advantage, CMS uses 100% of the 2024 CMS-HCC model (V28). PACE uses a separate model blend. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes.

Human immunodeficiency virus, type 2 (HIV 2) as the cause of diseases classified elsewhere, used when HIV-2 specifically is the causative organism for another documented condition. For B97.35, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule. When documentation is ambiguous, coders should issue a provider query rather than assume the highest-specificity variant.

HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for B97.35 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•Human immunodeficiency virus, type 2 (HIV 2) as the cause of diseases classified elsewhere, used when HIV-2 specifically is the causative organism for another documented condition.
•Distinguish HIV-1 (the predominant strain) from HIV-2 (rarer, geographically concentrated). Lab typing must support the HIV-2 designation.
•When HIV-2 is documented as the cause of another condition, the B97.35 code itself captures the HIV HCC.

Clinical Significance

HIV-2 as cause of disease classified elsewhere identifies the specific viral strain when HIV-2 is the underlying etiology. HIV-2 is less common globally than HIV-1 and is primarily found in West Africa. It progresses more slowly and is inherently resistant to non-nucleoside reverse transcriptase inhibitors, making identification critical for treatment selection. This code maps to the highest-tier HIV/AIDS HCC.

Documentation Requirements

✓Confirmatory HIV-2 serologic testing (HIV-2 specific Western blot or differentiation assay)
✓Documentation that the infection is specifically HIV-2, not HIV-1 or dual infection
✓The primary manifestation/condition being caused by HIV-2 must also be coded
✓Current antiretroviral regimen documented (noting NNRTI resistance)
✓CD4 count and HIV-2 viral load if available

Commonly Confused Codes

•B20 (HIV disease resulting in infectious and parasitic diseases) - B20 is used for symptomatic HIV disease as the primary diagnosis; B97.35 is the supplementary causative agent code
•Z21 (Asymptomatic HIV infection status) - use for asymptomatic HIV, not as a causative agent code
•B97.33 (HIV-1 as the cause) - different strain; HIV-2 has different treatment implications and drug resistance