ICD Code B97.4

ICD code B97.4 is respiratory syncytial virus identified as the cause of diseases that are classified under other primary diagnoses.

1. Laboratory-confirmed presence of respiratory syncytial virus (RSV) in the patient

2. Clinical diagnosis of a disease or condition (such as pneumonia, bronchiolitis, or other respiratory illness) that is classified elsewhere in the ICD coding system

3. Clear documentation that RSV is the underlying or contributing cause of the diagnosed disease

4. Symptoms consistent with RSV infection, such as cough, wheezing, difficulty breathing, or increased respiratory effort

5. Exclusion of other primary viral or bacterial pathogens as the main cause of the disease

6. Supporting clinical findings, such as abnormal chest auscultation, hypoxemia, or radiographic evidence of lower respiratory tract involvement

Relevant CPT codes that may be used to treat ICD code B97.4 include:

- 87807 (Infectious agent antigen detection by immunoassay with direct optical observation; respiratory syncytial virus)

- 87252 (Viral culture; respiratory syncytial virus, isolation)

- 87634 (Infectious agent detection by nucleic acid [DNA or RNA]; respiratory syncytial virus, direct probe technique)

- 87636 (Infectious agent detection by nucleic acid [DNA or RNA]; influenza virus and respiratory syncytial virus, multiplex amplified probe technique)

- 96372 (Therapeutic, prophylactic, or diagnostic injection [specify substance or drug]; subcutaneous or intramuscular)

- 99202–99215 (Evaluation and management services, new or established patient, depending on visit complexity)

- 94640 (Pressurized or non-pressurized inhalation treatment for acute airway obstruction or for sputum induction for diagnostic purposes)

CPT code selection should be based on the specific services rendered and clinical documentation.

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