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HIV Guidelines Updated for FY2026

FY2026 coding updates provide a good clarification in the HIV guidelines about patients who are on antiretroviral medication. The bottom line is…does the patient currently have or ever had HIV disease, an HIV-related illness or AIDS? If so, B20 (Human Immunodeficiency Virus (HIV) disease).

* If a patient with documented HIV disease, HIV-related illness or AIDS is currently managed on antiretroviral medications, assign code B20, Human immunodeficiency virus [HIV] disease.

* If a patient with documented HIV positive status is currently managed on antiretroviral medication, assign code Z21, Asymptomatic human immunodeficiency virus [HIV] infection status, in the absence of any additional documentation of HIV disease, HIV-related illness or AIDS.

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The information and opinions presented here are based on the experience, training, and interpretation of e4health. Although the information has been researched and reviewed for accuracy, e4health does not accept any responsibility or liability regarding errors, omissions, misuse, or misinterpretation. This information is intended as a guide; it should not be considered a legal/consulting opinion or advice.