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Thursday Mar 05, 2020

Coding for the new coronavirus and COVID-19 illness

Editor's note: This post was updated March 19, after the Centers for Disease Control and Prevention moved up the effective date for a new diagnosis code for COVID-19 from Oct. 1 to April 1.

Family physicians should prepare to use recent coding guidance from the Centers for Disease Control and Prevention (CDC) for exposure to the novel 2019 coronavirus and the illness it causes, COVID-19.

There is no specific code for COVID-19 in the U.S. at this time, but one is coming soon. The World Health Organization (WHO) has already added code U07.1 (2019-nCoV acute respiratory disease) to the international ICD-10, and the CDC recently announced(www.cdc.gov) that the same code would be added to the U.S. ICD-10-CM list effective April 1. Starting on that day, U07.1 should be used to report a patient who has tested positive for COVID-19.

Until then, the CDC has published the following interim guidance on coding for this condition:

  • For a diagnosis of COVID-19, report the code for the patient condition that is related to the COVID-19 (e.g., J12.89, "Other viral pneumonia") and B97.29, "Other coronavirus as the cause of diseases classified elsewhere."
The following guidance applies before and after the diagnosis code takes effect:
  • For suspected COVID-19, not confirmed or ruled out at the encounter, report codes for the presenting signs and symptoms. Do not report a code for coronavirus when this diagnosis is not stated in the medical record.
  • For known exposure to COVID-19 (without diagnosis of COVID-19), report Z20.828, "Contact with and (suspected) exposure to other viral communicable diseases."
  • For suspected exposure to COVID-19 that is ruled out after evaluation, report Z03.818, "Encounter for observation for suspected exposure to other biological agents ruled out."

Stay tuned as the WHO and CDC continue to monitor and respond to this emerging health issue. Find the most up-to-date coding guidance from the CDC at https://www.cdc.gov/nchs/icd/icd10cm.htm(www.cdc.gov).

AAFP has general information about how to prepare for COVID-19 here: https://www.aafp.org/patient-care/emergency/2019-coronavirus.html

— Cindy Hughes, CPC, CFPC

Posted at 03:15PM Mar 05, 2020 by Cindy Hughes

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