B97.39 ICD-10-CM Code: Other retrovirus as the cause of diseases classified elsewhere
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FY 2026 Apr update / Certain infectious and parasitic diseases (A00-B99) / Bacterial and viral infectious agents (B95-B97)
B97.39
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceOther retrovirus as the cause of diseases classified elsewhere
This code identifies a retrovirus (a type of virus that includes HIV and similar viruses) other than HIV as the underlying cause of a disease or condition documented in the patient's medical record. It is used as a secondary code to indicate the infectious agent responsible for the patient's illness.
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
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Inclusion Terms
OfficialICD-10-CM does not list inclusion terms for B97.39 in this effective period.
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for B97.39 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for B97.39 in this effective period.
Excludes 1
Official- Human immunodeficiency virus [HIV] disease (B20)
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for B97.39 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for B97.39 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for B97.39 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 B97.39 an HCC code?
No. B97.39 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
B97.39 is the ICD-10-CM diagnosis code for other retrovirus as the cause of diseases classified elsewhere. This code identifies a retrovirus (a type of virus that includes HIV and similar viruses) other than HIV as the underlying cause of a disease or condition documented in the patient's medical record. It is used as a secondary code to indicate the infectious agent responsible for the patient's illness. B97.39 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).
B97.39 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.
This is a cause-of-disease code and should be used as a secondary diagnosis code paired with the primary condition it caused; never use it as the primary diagnosis.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for B97.39 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This is a cause-of-disease code and should be used as a secondary diagnosis code paired with the primary condition it caused; never use it as the primary diagnosis
- •Verify the specific retrovirus type is documented in the medical record; if HIV is confirmed, use B20 instead; if the retrovirus type is specified (like HTLV-1 or HTLV-2), consider using more specific codes like B97.33 or B97.34