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The CDC Posts Interim ICD-10-CM Coding Guidance

The CDC recently posted supplemental information to provide coding guidance for healthcare services related to the 2019 novel coronavirus (COVID-19).  This general guidance is intended to be used in conjunction with ICD-10-CM and will be updated to reflect new clinical information as it develops.

EXPOSURE AND POSSIBLE EXPOSURE TO COVID-19

For cases of actual exposure to someone who is confirmed to have COVID-19:
Z20.828, Contact with and (suspected) exposure to other viral communicable diseases

For cases where there is concern about possible exposure to COVID-19, but is ruled-out after evaluation:
Z03.818, Encounter for observation for suspected exposure to other biological agents ruled out

CONDITIONS DUE TO, OR ASSOCIATED WITH, COVID-19

In many cases, a combination of ICD-10-CM codes will be needed to adequately report the condition and its relation to COVID-19.  Here, the condition itself will have its own code(s) reported in conjunction with B97.29, Other coronavirus as the cause of diseases classified elsewhere.  For example:

Lower respiratory infections, not otherwise specified (NOS); or acute respiratory infections, NOS, documented as associated with COVID-19 would be reported as:
•    J22, Unspecified acute lower respiratory infection and 
•    B97.29, Other coronavirus as the cause of diseases classified elsewhere

Pneumonia confirmed as due to COVID-19:
•    J12.89, Other viral pneumonia and
•    B97.29, Other coronavirus as the cause of diseases classified elsewhere

SIGNS AND SYMPTOMS WITHOUT A DEFINITIVE DIAGNOSIS

When patients present with signs and symptoms but a definitive diagnosis has not been made, only the ICD-10-CM code for each sign and symptom should be reported.  In this case it is not appropriate to report the coronavirus code, B97.29.  For example:
•    R50.9, Fever, unspecified
•    R05, Cough
•    R06.02, Shortness of breath

Obtain additional detail at:
https://www.cdc.gov/nchs/data/icd/ICD-10-CM-Official-Coding-Gudance-Interim-Advice-coronavirus-feb-20-2020.pdf

NEW ICD-10-CM FOR COVID-19

The CDC has announced that a new ICD-10-CM code will be released on April 1, 2020 for the COVID-19 virus due to the urgent need to capture the reporting of this pandemic condition.

•    U07.1, COVID-19

With this new code set to be in place, we expect to see more guidelines sent out by the CDC and CMS in the near future regarding the effective date of service and the filing claims before that time frame.

Obtain additional detail at:
https://www.cdc.gov/nchs/data/icd/Announcement-New-ICD-code-for-coronavirus-3-18-2020.pdf

APS will continue to stay current on this ongoing topic and provide any updates when we receive any new information from CMS and/or the CDC.
 

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