Coding for COVID-19
Thursday, March 12, 2020
Posted by: Practice Resources
Written By: Heather Macre
The 2019 novel coronavirus (COVID-19) has been dominating the news cycle and new cases are being diagnosed all over the country. While there has been a lot of information about the signs and symptoms to look out for, there has been little information for providers as to how to describe the virus in terms of ICD-10-CM coding. Providers are likely to see an increased number of patients seeking treatment and testing for the signs and symptoms of COVID-19, so they need to know how to code appropriately.
On February 20, 2020, the CDC released revised guidance to help providers appropriately code for COVID-19 cases. Starting April 1, 2020, Code U0001 can be used to denote a new lab test specific to COVID-19. This code should be used for CDC testing laboratories.
Further, since COVID-19 typically presents within a range of illnesses, the following can be used depending on the accompanying diagnosis:
- Code J20.8 for acute bronchitis due to COVID-19
- Code J40 for bronchitis not otherwise specified (NOS) caused by COVID-19
- Code J22 for lower respiratory infection NOS or acute respiratory infection caused by COVID-19
- Code J98.9 for a respiratory infection NOS caused by COVID-19
- Code J80 for acute respiratory distress syndrome due to COVID-19
- Code Z03.818 for cases where there is concern about possible COVID-19 exposure but exposure is ruled out after evaluation
- Code Z20.828 for actual exposure to a confirmed case of COVID-19
- Code for signs and symptoms associated with COVID-2019:
- R05 (Cough),
- R06.02 (Shortness of breath) or
- R50.9 (Fever, unspecified).
Providers have also been advised not to use Code B34.2 as it refers to an unspecified corona virus infection whereas COVID-19 has been respiratory in nature. Instead, if a provider suspects a COVID-19 infection, he or she should assign a code that explains the reason for the encounter or concern.
In addition, on March 5, 2020, the Center for Medicare & Medicaid Services (“CMS”) released additional coding information. CMS’s release states that testing Code U0001 should only be used in CDC laboratories and that a second code, Code U0002, should be used in labs using other, non-CDC-created types of tests.
The CDC intends to provide coding further information in its October 1 update, but for now these codes should be used to correctly denote COVID-19 cases. Additional information is available in the CDC’s guidance document, which is available at here.
Providers should continue to monitor the CDC’s COVID-19 page for updates as well. The CDC has guidance on how to protect yourself, common diagnostic information for COVID-19 and more.
Finally, CMS has released guidance on its payment policies relative to COVID-19 which are available as follows:
About the Author:
Heather Macre is an Arizona attorney specializing in healthcare law. Ms. Macre is a Director with Fennemore Craig, PC in Phoenix. Her work in the healthcare arena encompasses all aspects of healthcare agreements, such as hospital recruitment agreements, employment agreements and non-compete covenants, and office-sharing agreements. She also provides professional representation in licensure and disciplinary proceedings, and in matters concerning HIPAA and Stark and False Claims Act compliance.
Click HERE for further information on COVID-19.