Symptomatic HIV infection means that an individual has HIV infection which is accompanied by signs, symptoms,
or disease manifestations which could reasonably be expected to be related to HIV
infection.
Use 0430 as the primary diagnosis code when symptomatic HIV infection is the basis
for allowance. The following must apply:
-
•
meets or medically equals the HIV listing;
-
•
medical-vocational allowance; or
-
Follow DI 26510.015G.4. for the secondary diagnosis codes to use when symptomatic HIV infection is the primary
diagnosis.
REMEMBER: Do not use code 0430 as the primary diagnosis code when the basis for the allowance
is not HIV infection even if the claimant has symptomatic HIV infection. This includes
cases in which the allowance is based on an unrelated impairment or in which an HIV-infected
person has an impairment(s) that meets or equals another listing. In such cases, follow
the rules in DI
26510.015C. to determine whether code 0430 should be the secondary diagnosis code.
For symptomatic HIV infection cases that are denied, that is, as medical-vocational
decisions for adults or functional equals decisions for children, follow DI 26510.015C. to determine whether to use code 0430 as the primary or secondary diagnosis.