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Acute infectious mononucleosis A047

Document
Last amended 
29 May 2015
Current RMA Instruments:
Reasonable Hypothesis SOP
3 of 2012
Balance of Probabilities SOP
4 of 2012
Changes from Previous Instruments:

SOP Bulletin 156

ICD Coding:
  • ICD-9-CM Codes: 075
  • ICD-10-AM Codes: B27.0
Is specific diagnostic evidence required to apply the SOP?  Yes

Laboratory evidence of recently acquired Epstein-Barr virus infection (see comments), plus evidence of a concurrent clinical illness compatible with acute Epstein-Barr virus infection.

Are there sub-factors that require specific information?  No.
Additional diagnoses covered by SOP
  • Glandular fever (but see conditions not covered)
  • Acute infectious mononucleosis - resolved (see comments)
  • Symptomatic Epstein-Barr virus infection
Conditions not covered by SOP
  • Asymptomatic Epstein-Barr virus infection - N.I.F.
  • Chronic fatigue syndrome, ICD code 780.7
  • Glandular fever due to cytomegalovirus infection, ICD code 078.5
  • Infectious mononucleosis due to cytomegalovirus infection, ICD code 078.5
Unconfirmed diagnosis

If, after applying the above information, you are unable to confirm the diagnosis, you should then:

  1. seek medical officer advice about further investigation, or;
  2. re-encode the condition, if appropriate.

The following investigations may be useful in establishing the diagnosis.

  • A report from a physician or general practitioner, describing the symptoms and signs of the relevant clinical illness, as well as details of Epstein-Barr virus serology.
Comments

A claim for previously symptomatic Epstein-Barr virus infection, that has now resolved, can be diagnosed as "acute infectious mononucleosis - resolved" and determined using the SOP.

Epstein-Barr virus serology – a primary EBV infection is indicated if IgM antibody to the viral capsid antigen is present and antibody to EBV nuclear antigen (EBNA) is absent.  A rising or high IgG antibody to the viral capsid antigen and negative antibody to EBNA after at least 4 weeks of illness is also strongly suggestive of primary infection. In addition, 80% of patients with active EBV infection produce antibody to early antigen.