ICD-10 · PDGM grouping
B20 Human immunodeficiency virus [HIV] disease
The one code in the B20 family, with the PDGM clinical group, comorbidity subgroup and primary-position rule CMS assigns, read from the CMS grouper crosswalk v07.2.26 and the CDC FY2027 code file.
Codes in family
1
Can lead a claim
1
Cannot lead a claim
0
What CMS assigns to B20
This code groups to MMTA - Infectious Disease, Neoplasms, and Blood-Forming Diseases. It counts toward the C-diff, MRSA, E-coli, Sepsis comorbidity subgroup. It can lead a claim. CMS attaches a code-first note to it.
- C-diff, MRSA, E-coli, Sepsis: counts toward the high comorbidity tier only in an interaction pair.
Code first
CMS grouper convention 3. Code first:
- Human immunodeficiency virus [HIV] disease complicating pregnancy, childbirth and the puerperium, if applicable (O98.7-)
The B20 code
Descriptions are CDC’s FY2027 wording; where CMS’s grouper abbreviates one, its form is shown beneath.
| Code | Description | Primary position | Clinical group | Comorbidity subgroup |
|---|---|---|---|---|
| B20 | Human immunodeficiency virus [HIV] disease | Can lead a claim, code first applies | K | C-diff, MRSA, E-coli, Sepsis |
Sources: CMS HH PPS Grouper Software v07.2.26, effective 2026-10-01, for the clinical group, comorbidity subgroup, code-first conventions and primary-position flags; CDC NCHS ICD-10-CM FY2027 code descriptions for the family title and code wording. This is the crosswalk Medicare runs a claim through. Grouping also depends on admission source, timing, the OASIS functional items and the rest of the diagnosis list.
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