CODING & DOCUMENTATION

Special COVID-19 edition

 

Fam Pract Manag. 2020 Sep-Oct;27(5):41.

Author disclosure: no relevant financial affiliations disclosed.

CODING FOR COVID-19 WHEN TESTING ISN'T AVAILABLE

Q

How should I code for COVID-19 when testing is unavailable or delayed?

A

The World Health Organization created two diagnosis codes for COVID-19: one for labconfirmed cases (U07.1, “COVID-19, virus identified”) and one for clinically diagnosed cases (U07.2, “COVID-19, virus not identified”). But so far the United States has adopted only one: U07.1, “COVID-19.”

That means U07.1 should be used when you believe a patient has COVID-19 based on your clinical judgment, with or without test results. You should also code for any manifestations the patient may have (e.g., lower respiratory infection, viral enteritis), but U07.1 can stand alone if the patient is asymptomatic.

If you think a patient has been exposed to the novel coronavirus but you are uncertain about the diagnosis and tests are unavailable or results are pending, you should report Z20.828, “Contact with and (suspected) exposure to other viral communicable diseases” and codes for the patient's symptoms.

You should also report Z20.828 when an asymptomatic patient fears prior exposure to COVID-19 but current infection is not diagnosed during the visit.

See the ICD-10-CM Official Guidelines for Coding and Reporting FY 2021 (https://www.cdc.gov/nchs/data/icd/10cmguidelines-FY2021.pdf) for other COVID-19 diagnosis coding guidance.

COVID-19 DIAGNOSIS CODES FOR RECOVERED PATIENTS

Q

What diagnosis code should be reported for follow-up visits with patients who have recovered from COVID-19?

A

Report codes Z09, “Encounter for follow-up examination after completed treatment for conditions other than malignant neoplasm,” and Z86.19, “Personal history of other infectious and parasitic diseases,” when the patient no longer has COVID-19.

ABOUT THE AUTHOR

Cindy Hughes is an independent consulting editor based in El Dorado, Kan., and a contributing editor to FPM.

Author disclosure: no relevant financial affiliations disclosed.

WE WANT TO HEAR FROM YOU

Send questions and comments to fpmedit@aafp.org, or add your comments below. While this department attempts to provide accurate information, some payers may not accept the advice given. Refer to the current CPT and ICD-10 coding manuals and payer policies.

 
 

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