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B97.4

Billable

Respiratory syncytial virus as the cause of diseases classified elsewhere

This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).

What This Code Means

Respiratory syncytial virus (RSV) is identified as the underlying cause of another disease or condition being treated.

Coding Tips

  • Use this code as a secondary diagnosis with the primary code describing the respiratory condition (bronchiolitis, pneumonia, etc.) caused by RSV
  • RSV is common in infants and young children; ensure the primary diagnosis code reflects the specific respiratory manifestation

Excludes 1 — Do NOT code together

  • acute bronchiolitis due to respiratory syncytial virus (RSV) (J21.0)
  • acute bronchitis due to respiratory syncytial virus (RSV) (J20.5)
  • respiratory syncytial virus (RSV) pneumonia (J12.1)

Code First

  • related disorders, such as:
  • otitis media (H65.-)
  • upper respiratory infection (J06.9)

Code Hierarchy

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