B97.4 ICD-10-CM Code: Respiratory syncytial virus as the cause of diseases classified elsewhere

B97.4 is the ICD-10-CM diagnosis code for respiratory syncytial virus as the cause of diseases classified elsewhere. Respiratory syncytial virus (RSV) is identified as the underlying cause of another disease or condition being treated. B97.4 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).

B97.4 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 this code as a secondary diagnosis with the primary code describing the respiratory condition (bronchiolitis, pneumonia, etc.) caused by RSV.