Practices may have at least five new COVID-related diagnosis codes to use starting in January 2021, according to updates announced today. The new codes would be in addition to the ICD-10-CM code and guideline changes set to take effect Oct. 1 this year.
In response to “multiple requests for related codes,” the ICD-10 Coordination and Maintenance Committee
today said it is considering adding three new Z codes to the code set:
- Z11.52, (Encounter for screening for COVID-19), reported for people who are asymptomatic.
- Z20.822 (Contact with and [suspected] exposure to COVID-19).
- Z86.16 (Personal history of COVID-19).
A new J code would allow providers to report COVID-caused pneumonia with one code instead of two:
- J12.82 (Pneumonia due to coronavirus disease 2019), which includes the inclusion terms, “Pneumonia due to COVID-19” and “Pneumonia due to 2019 novel coronavirus (SARS-CoV-2).”
The committee proposed the new combined coronavirus pneumonia code to “improve coding specificity for pneumonia due to coronavirus disease,” the agency stated.
Existing coding guidance for COVID-related pneumonia instructs coders to report two diagnosis codes for the condition:
U07.1 (COVID-19) and
J20.89 (Other viral pneumonia).
However, the committee said it needed to draft the combined code J12.82 after an investigation of CMS data showed that using two codes “may substantially under-record pneumonia-related COVID-19, with more than 50% of recorded COVID-19 cases having had ‘other viral pneumonia’ recorded.”
A new M code would report multisystem inflammatory syndrome that has been associated with COVID-19, particularly in children:
- M35.81 (Multisystem inflammatory syndrome).
The code, proposed by researchers at the Centers for Disease Control and Prevention (CDC), would apply in cases that involve “fever, laboratory markers of inflammation, severe illness requiring hospitalization with at least 2 organ systems involved and laboratory evidence of SARS-CoV-2 infection (by RT-PCR, serology, or antigen test) or a history of known exposure to a suspected or confirmed COVID-19 case within 4 weeks prior to symptom onset,” according to the current CDC definition.
Comments on the proposed changes are due Oct. 9.
Payer representatives who attended the virtual committee meeting, including those from America’s Health Insurance Plans (AHIP) and Humana, welcomed the changes and said they would be ready to implement them Jan. 1.
David Berglund, M.D., a staff member on the ICD-10 Coordination and Maintenance Committee said the panel is committed to launching the codes sometime in January, and is shooting for a Jan. 1 implementation date.