2020 ICD-10-CM Diagnosis Code B97.4

Respiratory syncytial virus as the cause of diseases classified elsewhere

    2016 2017 2018 2019 2020 Billable/Specific Code
  • B97.4 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.
  • Short description: Respiratory syncytial virus causing diseases classd elswhr
  • The 2020 edition of ICD-10-CM B97.4 became effective on October 1, 2019.
  • This is the American ICD-10-CM version of B97.4 - other international versions of ICD-10 B97.4 may differ.
Applicable To
  • RSV as the cause of diseases classified elsewhere
Code First
Code First Help
Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. For such conditions, ICD-10-CM has a coding convention that requires the underlying condition be sequenced first followed by the manifestation. Wherever such a combination exists there is a "use additional code" note at the etiology code, and a "code first" note at the manifestation code. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation. In most cases the manifestation codes will have in the code title, "in diseases classified elsewhere." Codes with this title are a component of the etiology/manifestation convention. The code title indicates that it is a manifestation code. "In diseases classified elsewhere" codes are never permitted to be used as first listed or principle diagnosis codes. They must be used in conjunction with an underlying condition code and they must be listed following the underlying condition.
  • related disorders, such as:
  • otitis media (
    ICD-10-CM Diagnosis Code H65
    • H65 Nonsuppurative otitis media
      • H65.0 Acute serous otitis media
        • H65.00 …… unspecified ear
        • H65.01 …… right ear
        • H65.02 …… left ear
        • H65.03 …… bilateral
        • H65.04 Acute serous otitis media, recurrent, right e...
        • H65.05 Acute serous otitis media, recurrent, left ea...
        • H65.06 Acute serous otitis media, recurrent, bilater...
        • H65.07 Acute serous otitis media, recurrent, unspeci...
      • H65.1 Other acute nonsuppurative otitis media
        • H65.11 Acute and subacute allergic otitis media (muc...
          • H65.111 Acute and subacute allergic otitis media (muc...
          • H65.112 Acute and subacute allergic otitis media (muc...
          • H65.113 Acute and subacute allergic otitis media (muc...
          • H65.114 Acute and subacute allergic otitis media (muc...
          • H65.115 Acute and subacute allergic otitis media (muc...
          • H65.116 Acute and subacute allergic otitis media (muc...
          • H65.117 Acute and subacute allergic otitis media (muc...
          • H65.119 Acute and subacute allergic otitis media (muc...
        • H65.19 Other acute nonsuppurative otitis media
          • H65.191 Other acute nonsuppurative otitis media, righ...
          • H65.192 Other acute nonsuppurative otitis media, left...
          • H65.193 Other acute nonsuppurative otitis media, bila...
          • H65.194 Other acute nonsuppurative otitis media, recu...
          • H65.195 Other acute nonsuppurative otitis media, recu...
          • H65.196 Other acute nonsuppurative otitis media, recu...
          • H65.197 Other acute nonsuppurative otitis media recur...
          • H65.199 Other acute nonsuppurative otitis media, unsp...
      • H65.2 Chronic serous otitis media
      • H65.3 Chronic mucoid otitis media
      • H65.4 Other chronic nonsuppurative otitis media
        • H65.41 Chronic allergic otitis media
        • H65.49 Other chronic nonsuppurative otitis media
          • H65.491 Other chronic nonsuppurative otitis media, ri...
          • H65.492 Other chronic nonsuppurative otitis media, le...
          • H65.493 Other chronic nonsuppurative otitis media, bi...
          • H65.499 Other chronic nonsuppurative otitis media, un...
      • H65.9 Unspecified nonsuppurative otitis media
        • H65.90 Unspecified nonsuppurative otitis media, unsp...
        • H65.91 Unspecified nonsuppurative otitis media, righ...
        • H65.92 Unspecified nonsuppurative otitis media, left...
        • H65.93 Unspecified nonsuppurative otitis media, bila...
    H65.-
    )
  • upper respiratory infection (
    ICD-10-CM Diagnosis Code J06.9

    Acute upper respiratory infection, unspecified

      2016 2017 2018 2019 2020 Billable/Specific Code
    Applicable To
    • Upper respiratory disease, acute
    • Upper respiratory infection NOS
    Use Additional
    • code (B95-B97) to identify infectious agent, if known, such as:
    • respiratory syncytial virus (RSV) (B97.4)
    J06.9
    )
Type 2 Excludes
Type 2 Excludes Help
A type 2 excludes note represents "not included here". A type 2 excludes note indicates that the condition excluded is not part of the condition it is excluded from but a patient may have both conditions at the same time. When a type 2 excludes note appears under a code it is acceptable to use both the code (B97.4) and the excluded code together.
  • acute bronchiolitis due to respiratory syncytial virus (RSV) (
    ICD-10-CM Diagnosis Code J21.0

    Acute bronchiolitis due to respiratory syncytial virus

      2016 2017 2018 2019 2020 Billable/Specific Code
    Applicable To
    • Acute bronchiolitis due to RSV
    J21.0
    )
  • acute bronchitis due to respiratory syncytial virus (RSV) (
    ICD-10-CM Diagnosis Code J20.5

    Acute bronchitis due to respiratory syncytial virus

      2016 2017 2018 2019 2020 Billable/Specific Code
    Applicable To
    • Acute bronchitis due to RSV
    J20.5
    )
  • respiratory syncytial virus (RSV) pneumonia (
    ICD-10-CM Diagnosis Code J12.1

    Respiratory syncytial virus pneumonia

      2016 2017 2018 2019 2020 Billable/Specific Code
    Applicable To
    • RSV pneumonia
    J12.1
    )
The following code(s) above B97.4 contain annotation back-references
Annotation Back-References
In this context, annotation back-references refer to codes that contain:
  • Applicable To annotations, or
  • Code Also annotations, or
  • Code First annotations, or
  • Excludes1 annotations, or
  • Excludes2 annotations, or
  • Includes annotations, or
  • Note annotations, or
  • Use Additional annotations
that may be applicable to B97.4:
  • A00-B99
    2020 ICD-10-CM Range A00-B99

    Certain infectious and parasitic diseases

    Includes
    • diseases generally recognized as communicable or transmissible
    Type 1 Excludes
    • certain localized infections - see body system-related chapters
    Type 2 Excludes
    • carrier or suspected carrier of infectious disease (Z22.-)
    • infectious and parasitic diseases complicating pregnancy, childbirth and the puerperium (O98.-)
    • infectious and parasitic diseases specific to the perinatal period (P35-P39)
    • influenza and other acute respiratory infections (J00-J22)
    Use Additional
    • code to identify resistance to antimicrobial drugs (Z16.-)
    Certain infectious and parasitic diseases
  • B95-B97
    2020 ICD-10-CM Range B95-B97

    Bacterial and viral infectious agents

    Note
    • These categories are provided for use as supplementary or additional codes to identify the infectious agent(s) in diseases classified elsewhere.
    Bacterial and viral infectious agents
Approximate Synonyms
  • Respiratory syncytial virus infection
ICD-10-CM B97.4 is grouped within Diagnostic Related Group(s) (MS-DRG v37.0):
  • 791 Prematurity with major problems
  • 793 Full term neonate with major problems
  • 865 Viral illness with mcc
  • 866 Viral illness without mcc

Convert B97.4 to ICD-9-CM

Code History
  • 2016 (effective 10/1/2015): New code (first year of non-draft ICD-10-CM)
  • 2017 (effective 10/1/2016): No change
  • 2018 (effective 10/1/2017): No change
  • 2019 (effective 10/1/2018): No change
  • 2020 (effective 10/1/2019): No change
Code annotations containing back-references to B97.4:
  • Use Additional: J06.9
    ICD-10-CM Diagnosis Code J06.9

    Acute upper respiratory infection, unspecified

      2016 2017 2018 2019 2020 Billable/Specific Code
    Applicable To
    • Upper respiratory disease, acute
    • Upper respiratory infection NOS
    Use Additional
    • code (B95-B97) to identify infectious agent, if known, such as:
    • respiratory syncytial virus (RSV) (B97.4)

Diagnosis Index entries containing back-references to B97.4:

ICD-10-CM Codes Adjacent To B97.4
B97.21 SARS-associated coronavirus as the cause of diseases classified elsewhere
B97.29 Other coronavirus as the cause of diseases classified elsewhere
B97.3 Retrovirus as the cause of diseases classified elsewhere
B97.30 Unspecified retrovirus as the cause of diseases classified elsewhere
B97.31 Lentivirus as the cause of diseases classified elsewhere
B97.32 Oncovirus as the cause of diseases classified elsewhere
B97.33 Human T-cell lymphotrophic virus, type I [HTLV-I] as the cause of diseases classified elsewhere
B97.34 Human T-cell lymphotrophic virus, type II [HTLV-II] as the cause of diseases classified elsewhere
B97.35 Human immunodeficiency virus, type 2 [HIV 2] as the cause of diseases classified elsewhere
B97.39 Other retrovirus as the cause of diseases classified elsewhere
B97.4 Respiratory syncytial virus as the cause of diseases classified elsewhere
B97.5 Reovirus as the cause of diseases classified elsewhere
B97.6 Parvovirus as the cause of diseases classified elsewhere
B97.7 Papillomavirus as the cause of diseases classified elsewhere
B97.8 Other viral agents as the cause of diseases classified elsewhere
B97.81 Human metapneumovirus as the cause of diseases classified elsewhere
B97.89 Other viral agents as the cause of diseases classified elsewhere
B99 Other and unspecified infectious diseases
B99.8 Other infectious disease
B99.9 Unspecified infectious disease
C00 Malignant neoplasm of lip

Reimbursement claims with a date of service on or after October 1, 2015 require the use of ICD-10-CM codes.