Why should a coder take precaution when coding HIVor AIDS?

Why would a coder want to take special precaution when coding the dianosis of human immunodefiency virus or acquired immuneodeifiency syndrom?

HIV - The Human Immunodeficiency Virus is the infection a person gets before going in to full blown AIDS. This virus progresses in stages depending on how much of the virus is in your system.

AIDS - The Acquired Immunodeficiency Syndrome is the final stage of the virus if left untreated. It usually takes 12-13 years before reaching this final stage.

I would think the coder would have to be cautious because having HIV doesn't necessarily mean you have or will have AIDS. There is such a stigma surrounding AIDS even today, that I would think the health insurance companies would have concerns between a diagnosis of HIV vs. AIDS.

Because unless the diagnosis is rock-solid, you could be giving a death sentence to that individual. You may send him or his family into shock, severe depression, or even suicide. And the insurance company will almost certainly start playing games (deny services, declare a re-existing condition). Thus, in the future, ANY medical problem that he/she developes can be denied as being related to HIV/AIDS and ANY medication that he might need would be denied for the same reason. Not only that, but the insurance company will do everything in its power to get rid of the patient so that they won't have to pay for his medical expenses. I know that thy're not supposed to do that. And I know that in sworn testimony before congress, the insurance company execs all swear that they don't do that. And I also know that there are a lot of liars out there!

In addition to the excellent answers already given, someone needs to throw in that AIDS continues to mutate. Already there are several new types, which are hundreds of times more infectious (and faster) than the original type, and these spontaneously generate in existing latent or active patients who have a less vigorous strain, at unforeseen times. The original dictum that one cannot catch the disease from casual contact, does not always hold up. Things like piercings in public school PE classes (and similar situations) cause the knowledgeable to shudder. So the ANSWER must include various forms of caution! Regards, Larry.