CDC: Here’s how to code COVID-19 cases

by Laura Evans, CPC on Feb 25, 2020
With the 2019 novel coronavirus (COVID-19) continuing to spread internationally, the coding world is catching up, little by little.
Recall that last week CMS issued a new lab test code specific to the virus – U0001, which takes effect April 1.
Now the CDC says it will issue a new code for the virus as part of its Oct. 1 update this year. The ICD-10 Coordination and Maintenance Committee will reveal the code, its final title and full addenda during its March 17-18 meeting in Baltimore.
In the interim, the committee on Feb. 20 released a supplement to its ICD-10-CM Official Coding Guidelines on how to report COVID-19 cases right now.
Because the virus can cause a range of different illnesses, typically two codes should be reported, the guidance states.
For example, a case of pneumonia confirmed to be caused by COVID-19 would be reported with codes J12.89 (Other viral pneumonia) and B97.29 (Other coronavirus as the cause of diseases classified elsewhere), the new guidelines instruct.
Here is additional CDC coding guidance for illnesses caused by COVID-19 included in the supplemental guidelines:
  • Acute bronchitis due to COVID-19: Assign code J20.8 (Acute bronchitis due to other specified organisms and B97.29.
  • Bronchitis not otherwise specified (NOS) caused by COVID-19: J40 (Bronchitis not specified as acute or chronic) and code B97.29.
Lower respiratory infection
  • Lower respiratory infection, not otherwise specified (NOS) or acute respiratory infection caused by COVID-19: Report code J22 (Unspecified acute lower respiratory infection) and code B97.29.
  • Respiratory infection NOS caused by COVID-19: Code J98.8 (Other specified respiratory disorders) and code B97.29.
Acute respiratory distress syndrome (ARDS)
  • ARDS due to COVID-19: Report codes J80 (Acute respiratory distress syndrome) and code B97.29.
Exposure to COVID-19
“For cases where there is concern about a possible exposure to COVID-19, but this is ruled out after evaluation,” report code Z03.818 (Encounter for observation for suspected exposure to other biological agents ruled out), the CDC instructs.
However, if there is actual exposure to a confirmed case of COVID-19, report code Z20.828 (Contact with and [suspected] exposure to other viral communicable diseases).
When the patient is exhibiting signs and symptoms but a definitive diagnosis has not been established, the CDC instructs that you code only the presenting signs and symptoms, such as:
  • R05 (Cough),
  • R06.02 (Shortness of breath) or
  • R50.9 (Fever, unspecified).
Don’t report code B34.2 (Coronavirus infection, unspecified) for COVID-19 “because the cases have universally been respiratory in nature, so the site would not be ‘unspecified,’” the CDC states.
Also, for suspected, possible or probable COVID-19, code only the symptoms or one of the exposure Z codes. Do not report code B97.29 unless the virus is confirmed.
WHO issues emergency U code, but not for use in the U.S.
The World Health Organization (WHO) on Jan. 31 issued an emergency ICD-10 code for the virus: U07.1 (2019-nCoV acute respiratory disease).
But that code is not for reporting in the U.S. It should be reported only in countries that use the WHO version of the ICD-10 code set.
In the U.S., where we use ICD-10-CM (CM stands for clinical modification), the ICD-10 Coordination and Maintenance Committee plans to issue a new code for the virus as part of its Oct. 1 update, as mentioned above.
Blog Tags: COVID-19, ICD-10
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