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Inpatient and Outpatient Effective: March, 2003

This policy applies to the documentation and coding of HIV and is in accordance with the AHA Coding Clinic guidelines of the 1994 Fourth Quarter.

Human Immunodeficiency Virus (HIV) Infections

Patients with any known prior diagnosis of an HIV-related illness should always be coded to 042. Once a patient has developed an HIV-related illness, the patient should always be assigned code 042 on every subsequent admission/encounter. Patients previously diagnosed with any HIV illness (042) should never be assigned to 795.71 or V08.

Code V08, Asymptomatic human immunodeficiency virus (HIV) infection, is applied when the patient without any documentation of symptoms is listed as being "HIV positive," "known HIV," "HIV test positive," or similar terminology. Do not use this code if the term "AIDS" is used or if the patient is treated for any HIV-related illness or is described as having any condition(s) resulting from his/her HIV positive status; use 042 in these cases.

In cases where the physician has not documented AIDS for patients that have HIV-related illness with no prior history of AIDS, the coder will process a "physician query form" for clarification.

All disputable cases are to be referred to the Data Quality Manager in the Medical Records Dept. at 973-972-3234

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