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AHA Coding Clinic issues COVID-19 diagnosis coding FAQ

Make sure to review a new set of frequently asked questions (FAQ) from the American Hospital Association (AHA) Coding Clinic for use of the new ICD-10-CM code U07.1 (COVID-19). 
Code U07.1 is on track to go live for use in the U.S. on April 1, as announced last week during the ICD-10 Coordination and Maintenance Meeting. The code was first issued at the end of January by the World Health Organization (WHO).
The ICD-10 Coordination and Maintenance Committee announced the new effective date on its website but offered no additional coding guidance for it. 
Instead, that role has been taken up by the AHA Coding Clinic -- also considered an authoritative resource for ICD-10 coding guidance.
Among the questions answered: 
Are there additional new codes to identify situations such as exposure to COVID-19 or observation for suspected COVID-19 when the tests are negative?
Not at the present time, according to Coding Clinic. “However, the Centers for Disease Control and Prevention’s National Center for Health Statistics, the U.S. agency responsible for maintaining ICD-10-CM in the US, is monitoring the situation.” 
So stay tuned for guidance on exposure and observation codes. In the meantime, continue to report existing “exposure to” Z codes for confirmed and suspected exposure cases and signs and symptoms R codes when coronavirus is not yet confirmed, as described in the interim official coding guidelines issued earlier this month.
Take note of other guidance from the Coding Clinic FAQ:
  • Code U07.1 is effective for services provided starting April 1. There is no retroactive reporting of the code for cases confirmed prior to that date. Instead, refer to the interim guidance mentioned above.
  • A copy of the positive test result is not required for a COVID-19 case to be considered “confirmed.” Instead, “the provider’s diagnostic statement that the patient has the condition would suffice,” the Coding Clinic FAQ states.
  • Code "presumptive" COVID-19 cases as confirmed. "A presumptive positive test result means an individual has tested positive for the virus at a local or state level, but it has not yet been confirmed" by the CDC, the Coding Clinic FAQ states. "CDC confirmation of local and state tests for the COVID-19 virus is no longer required."
As this story continues to develop, check back to this site and your DecisionHealth publications for the latest updates.
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