ICD-10-CM Code for Past EBV Infection
The ICD-10-CM code for past (resolved) Epstein-Barr virus infection is Z86.19 (Personal history of other infectious and parasitic diseases).
Primary Code Assignment
Z86.19 is the appropriate code when documenting a patient's history of previous EBV infection that has resolved, as there is no specific ICD-10-CM code dedicated solely to past EBV infection 1.
This code falls under the category of personal history codes (Z86.-), which are used to document conditions that no longer exist but are clinically relevant to the patient's current care 1.
Clinical Context for Code Selection
Past EBV infection is defined by the demonstration of positive serology (specifically VCA IgG positive with EBNA positive) in the absence of passive antibody transfer 1, 2.
The presence of EBNA antibodies indicates infection occurred more than 6 weeks prior and persists for life, confirming past rather than acute infection 2.
VCA IgG antibodies alone (without VCA IgM or with EBNA present) indicate previous exposure to EBV rather than active disease 1, 2.
When NOT to Use Z86.19
Do not use Z86.19 if the patient has detectable EBV viral load by nucleic acid amplification testing (NAAT), as this indicates active asymptomatic infection rather than past infection 1.
Do not use Z86.19 if the patient has chronic active EBV infection (CAEBV), which requires coding for the active disease state with very high VCA IgG titers (≥1:640) and EA IgG titers (≥1:160), plus EBV DNA loads >10^2.5 copies/mg DNA 1.
Do not use Z86.19 in immunocompromised patients with elevated EBV viral loads, as they require monitoring for EBV-associated lymphoproliferative disease and should be coded for active infection 1.
Alternative Codes for Active EBV States
B27.0- codes are used for current infectious mononucleosis with specific complications (B27.00 for mononucleosis without complication, B27.09 with other complications) 1.
Patients with EBV-associated lymphoproliferative disorders or malignancies require specific codes for those conditions rather than infection history codes 1, 3.