Frequently Asked Questions Regarding ICD-10-CM Coding for COVID-19

Revised August 27, 2021

The post-obit questions and answers were jointly developed and approved by the American Infirmary Association's Central Office on ICD-x-CM/PCS and the American Health Data Direction Association.

  • ICD-10-CM lawmaking U07.ane, COVID-xix, may exist used for discharges/date of service on or after April ane, 2020. For more information on this code, click here. The code was developed by the World Wellness Organization (WHO) and is intended to be sequenced first followed by the advisable codes for associated manifestations when COVID-19 meets the definition of principal or start-listed diagnosis. Specific guidelines for usage are available here. For guidance prior to April one, 2020, delight refer to the supplement to the ICD-10-CM Official Guidelines for coding encounters related to the COVID-19 coronavirus outbreak.

  • When COVID-19 meets the definition of main or first-listed diagnosis, code U07.one, COVID-nineteen, should exist sequenced commencement, and followed by the appropriate codes for associated manifestations, except when another guideline requires that certain codes be sequenced get-go, such every bit obstetrics, sepsis, or transplant complications. Withal, if COVID-19 does not come across the definition of principal or kickoff-listed diagnosis (e.g. when it develops after admission), then code U07.1 should exist used equally a secondary diagnosis.

  • The Centers for Disease Control and Prevention's National Centre for Health Statistics, the U.s.a. agency responsible for maintaining ICD-10-CM in the US, is implementing several new ICD-10-CM codes pertaining to COVID-19 on Jan 1, 2021. See ICD-10-CM FAQ #44 for further details.

  • The HIPAA code set standard for diagnosis coding in the U.s.a. is ICD-10-CM, not ICD-10. As shown in the Apr 1, 2020 Addenda on the CDC website, the only new code existence implemented in the Usa for COVID-xix is U07.ane.

  • Please refer to the supplement to the ICD-10-CM Official Guidelines for coding encounters related to the COVID-19 coronavirus outbreak. After April i, 2020, refer to the Official Guidelines for Coding and Reporting institute hither.

  • No, the code is not retroactive. Delight refer to the supplement to the ICD-10-CM Official Guidelines for coding encounters related to the COVID-nineteen coronavirus outbreak for guidance for coding of discharges/services provided earlier April 1, 2020.

  • No, code B97.29 is non exclusive to the SARS-CoV-two/2019-nCoV virus responsible for the COVID-19 pandemic. The code does non distinguish the more than thirty varieties of coronaviruses, some of which are responsible for the common common cold. Due to the heightened need to uniquely identify COVID-nineteen until the unique ICD-10-CM code is effective April 1, providers are urged to consider developing facility-specific coding guidelines that limit the assignment of lawmaking B97.29 to confirmed COVID-19 cases and foreclose the assignment of codes for any other coronaviruses.

  • Diagnosis code B34.2, Coronavirus infection, unspecified, would in generally not be appropriate for the COVID-nineteen, because the cases have universally been respiratory in nature, so the site of infection would not be "unspecified." Code B97.29, Other coronavirus as the cause of diseases classified elsewhere, has been designated as interim code to report confirmed cases of COVID-xix. Please refer to the supplement to the ICD-10-CM Official Guidelines for coding encounters related to the COVID-19 coronavirus outbreak for additional data. Because code B97.29 is not sectional to the SARS-CoV-two/2019-nCoV virus responsible for the COVID-19 pandemic, we are urging providers to consider developing facility-specific coding guidelines that limit the assignment of code B97.29 to confirmed COVID-19 cases and preclude the consignment of codes for whatever other coronaviruses.

  • Yes, the supplement applies to all patient types. Every bit stated in the supplement guidelines, "If the provider documents "suspected", "possible" or "probable" COVID-19, practice non assign code B97.29. Assign a code(s) explaining the reason for see (such as fever, or Z20.828, Contact with and (suspected) exposure to other viral and infectious disease."

  • The intent of the guideline is to code only confirmed cases of COVID-19. It is not required that a copy of the confirmatory test exist available in the record or documentation of the examination issue. The provider's diagnostic statement that the patient has the condition would suffice.

  • Yes, Presumptive positive COVID-19 examination results should be coded every bit confirmed. A presumptive positive test result means an individual has tested positive for the virus at a local or land level, just it has not yet been confirmed past the Centers for Disease Control and Prevention (CDC). CDC confirmation of local and land tests for the COVID-nineteen virus is no longer required.

  • Due to the heightened need to capture authentic data on positive COVID-19 cases, we recommend that providers consider developing facility-specific coding guidelines to hold dorsum coding of inpatient admissions and outpatient encounters until the test results for COVID-19 testing are bachelor. This advice is limited to cases related to COVID-19.

  • No, the provider does not need to explicitly link the examination issue to the respiratory condition, the positive exam results tin be coded as confirmed COVID-19 cases every bit long as the test result itself is part of the medical record. As stated in the coding guidelines for COVID-19 infections that went into consequence on April 1, code U07.1 may be assigned based on results of a positive test too as when COVID-19 is documented past the provider. Please note that this communication is limited to cases related to COVID-19 and not the coding of other laboratory tests. Due to the heightened demand to uniquely identify COVID-xix patients, we recommend that providers consider developing facility-specific coding guidelines to concur back coding of inpatient admissions and outpatient encounters until the exam results for COVID-19 testing are bachelor.

  • Yes, if a exam is performed during the visit or hospitalization, but results come dorsum afterwards discharge positive for COVID-19, and so it should be coded equally confirmed COVID-19.

  • Whether or not sepsis or U07.i is assigned as the master diagnosis depends on the circumstances of admission and whether sepsis meets the definition of principal diagnosis. For example, if a patient is admitted with pneumonia due to COVID-nineteen which so progresses to viral sepsis (not present on admission), the principal diagnosis is U07.1, COVID-xix, followed past the codes for the viral sepsis and viral pneumonia. On the other hand, if a patient is admitted with sepsis due to COVID-19 pneumonia and the sepsis meets the definition of principal diagnosis, so the code for viral sepsis (A41.89) should be assigned as master diagnosis followed by codes U07.one and the appropriate viral pneumonia lawmaking (J12.89, Other viral pneumonia, for discharges/encounters prior to January 1, 2021, or code J12.82, Pneumonia due to coronavirus illness 2019, for discharges/encounters after January 1, 2021) as secondary diagnoses.

  • Coding professionals should query the provider if the provider documented COVID-19 before the test results were back and the test results come back negative. Providers should exist given the opportunity to reconsider the diagnosis based on the new information.

  • If the provider still documents and confirms COVID-19 even though the test results are negative, or if the provider documented disagreement with the test results, assign code U07.1, COVID-19. Every bit stated in the Official Guidelines for Coding and Reporting for COVID-xix, "Code only a confirmed diagnosis of the 2019 novel coronavirus disease (COVID-19) as documented past the provider . . . the provider's documentation that the individual has COVID-nineteen is sufficient."

  • Assign codes Z09, Encounter for follow-up examination after completed treatment for conditions other than cancerous neoplasm, and the appropriate personal history code (code Z86.19, Personal history of other infectious and parasitic diseases, for encounters prior to January i, 2021, or code Z86.16, Personal history of COVID-19, for encounters after January i, 2021).

  • For an encounter for antibody testing that is not beingness performed to confirm a electric current COVID-nineteen infection, nor is being performed as a follow-up test subsequently resolution of COVID-19, assign Z01.84, Meet for antibody response exam.

  • Yes, both codes may be assigned, equally aspiration pneumonia and pneumonia due to COVID-xix are two divide unrelated conditions with dissimilar underlying causes. This scenario meets the exception to the Excludes1 guideline as a circumstance when the 2 conditions are unrelated to each other.

    Annotation that effective January 1, 2021, in that location is a new code, J12.82, for pneumonia due to coronavirus disease 2019.

  • Any immunocompromised patient (which would include HIV patients) is at higher risk for becoming infected with COVID-xix, but HIV does non cause COVID-19. Lawmaking both conditions separately, with sequencing depending on the circumstances of admission – just like a patient suffering from diabetes or any other chronic condition that puts them at higher risk for the COVID-19 infection.

  • At that place is no specific timeframe for when a personal history lawmaking is assigned. If the provider documents that the patient no longer has COVID-19, assign the advisable personal history code (code Z86.xix, Personal history of other infectious and parasitic diseases, for discharges/encounters prior to January 1, 2021, or code Z86.xvi, Personal history of COVID-xix, for discharges/encounters subsequently January 1, 2021).

  • People infected with COVID-19 may vary from being asymptomatic to having a range of symptoms and severity. Therefore, for coding purposes, signs and symptoms associated with COVID-nineteen may be coded separately, unless the signs or symptoms are routinely associated with a manifestation. For example, coughing would non be coded separately if the patient has pneumonia due to COVID-19, as coughing is a symptom of pneumonia. The boosted coding of signs or symptoms non explained by the manifestations would provide boosted information on the severity of the disease. Because COVID-xix is primarily a respiratory status, any other signs/symptoms would be coded separately unless another definitive diagnosis has been established for the other signs or symptoms. This is supported by Guideline IC.18.b, "Codes for signs and symptoms may exist reported in add-on to a related definitive diagnosis when the sign or symptom is not routinely associated with that diagnosis."

  • When coding the birth episode in a newborn record, the appropriate code from category Z38, Liveborn infants according to place of birth and type of commitment, should be assigned as the primary diagnosis. For a newborn that tests positive for COVID-19, assign code U07.ane, COVID-xix, and the appropriate codes for associated manifestation(s) in neonates/newborns in the absence of documentation indicating a specific type of transmission. For a newborn that tests positive for COVID-nineteen and the provider documents the condition was contracted in utero or during the birth process, assign codes P35.8, Other congenital viral diseases, and U07.1, COVID-xix.

  • Assign lawmaking T86.812, Lung transplant infection, as the principal or first-listed diagnosis, followed by code U07.1, COVID-nineteen. This sequencing is supported by the Tabular List note at code T86.812 to "use additional code to specify infection." The ICD-10-CM Official Guidelines for Coding and Reporting, Section I.C.19.g.3.a. land that "a transplant complexity code is only assigned if the complication affects the function of the transplanted organ." The COVID-19 infection has affected the office of the transplanted lung.

  • Assign code U07.ane, COVID-19, equally the principal diagnosis, and lawmaking J93.83, Other pneumothorax, as a secondary diagnosis. Since the pneumothorax due to COVID-19 present on the first admission has not resolved, this appears to be ongoing handling for a COVID-19 manifestation.

    If the documentation is non clear regarding whether the physician considers a condition to exist an acute manifestation of a electric current COVID-19 infection vs. a residue effect from a previous COVID-19 infection, query the provider. As stated in the Official Guidelines for Coding and Reporting, the provider's documentation that the private has COVID-19 is sufficient for coding purposes.

  • Assign code J93.83, Other pneumothorax, as the principal diagnosis, followed by code B94.8, Sequelae of other specified infectious and parasitic diseases, for discharges/encounters prior to October 1, 2021, or code U09.9, Postal service COVID-19 condition, unspecified, for discharges/encounters on or later on October one, 2021. In this case, the patient no longer has COVID-19 and the pneumothorax is a rest effect (sequelae). A personal history code is not appropriate because equally stated in guideline I.C.21.c.4), "Personal history codes explain a patient'due south past medical condition that no longer exists and is not receiving any treatment, but that has the potential for recurrence, and therefore may require continued monitoring." The patient is clearly receiving treatment for the residual effect of COVID-xix.

  • Assign code U07.1, COVID-19, as the principal diagnosis, followed by code I26.99, Other pulmonary embolism without acute cor pulmonale, for a patient diagnosed with pulmonary embolism and COVID-19. The pulmonary embolism is a manifestation of the COVID-19 infection. Per the instructional note under code U07.1, COVID-19 should be sequenced equally the chief diagnosis and boosted codes should be assigned for the manifestations.

  • Assign lawmaking I26.99, Other pulmonary embolism without acute cor pulmonale, equally the principal diagnosis, followed past code B94.8, Sequelae of other specified infectious and parasitic diseases, for discharges/encounters prior to Oct 1, 2021, or code U09.9, Post COVID-nineteen condition, unspecified, for discharges/encounters on or afterward October 1, 2021, as a secondary diagnosis.

  • Assign lawmaking U07.i, COVID-xix, every bit the patient yet has COVID-19. Do non assign a code for the pneumonia as the condition has resolved.

  • Assign code G61.0, Guillain-Barre syndrome, equally the principal diagnosis, followed by code B94.8, Sequelae of other specified infectious and parasitic diseases, for discharges/encounters prior to October 1, 2021, or code U09.nine, Post COVID-19 condition, unspecified, for discharges/encounters on or after Oct 1, 2021.

  • Assign code U07.one, COVID-19, equally the principal diagnosis, and code J96.01 Acute respiratory failure with hypoxia, as a secondary diagnosis. Per the instructional note under code U07.1, COVID-xix should be sequenced every bit the principal diagnosis and boosted codes should be assigned for the manifestations.

  • Assign codes G72.81, Disquisitional disease myopathy, and G57.31, Lesion of lateral popliteal nervus, correct lower limb. Assign code B94.viii, Sequelae of other specified infectious and parasitic diseases, for discharges/encounters prior to October ane, 2021, or lawmaking U09.ix, Post COVID-19 status, unspecified, for discharges/encounters on or after Oct 1, 2021, as a secondary diagnosis for the sequelae of a COVID-19 infection.

  • Assign codes for the specific symptoms (such as generalized weakness, debility, etc.). Assign the advisable personal history code (lawmaking Z86.nineteen, Personal history of other infectious and parasitic diseases, for discharges/encounters prior to January 1, 2021, or lawmaking Z86.16, Personal history of COVID-xix, for discharges/encounters after January 1, 2021) every bit a secondary diagnosis.

    Do non assign code B94.viii, Sequelae of other specified infectious and parasitic diseases, for discharges/encounters prior to October 1, 2021, or code U09.9, Post COVID-nineteen condition, unspecified, for discharges/encounters on or later on October 1, 2021, every bit the debility is due to the prolonged hospitalization rather than existence a sequela of the COVID-19 infection.

  • Assign code U07.i, COVID-19, as the chief diagnosis, and code M35.eight, Other specified systemic involvement of connective tissue, for discharges prior to January 1, 2021, or code M35.81, Multisystem inflammatory syndrome, for discharges afterwards January one, 2021, as a secondary diagnosis, for MIS-C due to COVID-xix. The MIS-C is a manifestation of the COVID-nineteen infection. Per the instructional note under code U07.1, COVID-xix should be sequenced equally the master diagnosis and additional codes should be assigned for the manifestations.

    If the documentation is non clear regarding whether the medico considers a status to be an acute manifestation of a current COVID-nineteen infection vs. a residual outcome from a previous COVID-19 infection, query the provider. As stated in the ICD-10-CM Official Guidelines for Coding and Reporting, the provider'due south documentation that the individual has COVID-19 is sufficient for coding purposes.

  • Assign lawmaking M35.8, Other specified systemic involvement of connective tissue, for discharges prior to January 1, 2021, or lawmaking M35.81, Multisystem inflammatory syndrome, for discharges after January 1, 2021, as the chief diagnosis, for the MIS-C, and code B94.viii, Sequelae of other specified infectious and parasitic diseases, for discharges/encounters prior to October 1, 2021, or code U09.9, Mail service COVID-19 condition, unspecified, for discharges/encounters on or after October 1, 2021, equally a secondary diagnosis for the sequelae of a COVID-19 infection.

    If the documentation is non clear regarding whether the physician considers a condition to be an acute manifestation of a current COVID-19 infection vs. a residual event from a previous COVID-19 infection, query the provider. As stated in the ICD-10-CM Official Guidelines for Coding and Reporting, the provider's documentation that the individual has COVID-19 is sufficient for coding purposes.

  • During the COVID-19 pandemic, a screening code is generally not advisable. For encounters for COVID-xix testing, including preoperative testing, code equally exposure to COVID-19 (code Z20.828 for encounters prior to January 1, 2021, or lawmaking Z20.822, Contact with and (suspected) exposure to COVID-xix, for encounters afterward January 1, 2021). The ICD-10-CM Official Guidelines for Coding and Reporting land that codes in category Z20, Contact with and (suspected) exposure to communicable diseases, are for patients who are suspected to have been exposed to a disease by close personal contact with an infected individual or are in an area where a illness is epidemic.

    For an encounter for COVID-19 testing being performed as office of preoperative testing, assign code Z01.812, Encounter for preprocedural laboratory test, equally the kickoff-listed diagnosis and assign code Z20.828 or Z20.822 (depending on the encounter date) every bit an additional diagnosis.

    Coding guidance will exist updated equally new data concerning any changes in the pandemic status becomes available.

    Annotation: This advice is consequent with the updated ICD-ten-CM Official Guidelines for Coding and Reporting that get effective October 1, 2020. During these unprecedented times, AHA and AHIMA concluded information technology was necessary to analyze the appropriate codes for COVID-19 testing in advance of the effective appointment for the revised official coding guidelines.

  • For asymptomatic individuals with bodily or suspected exposure to COVID-19, assign code Z20.828, Contact with and (suspected) exposure to other viral communicable diseases, for encounters prior to January 1, 2021, and lawmaking Z20.822, Contact with and (suspected) exposure to COVID-19, for encounters after January 1, 2021.

    For symptomatic individuals with actual or suspected exposure to COVID-19 and the infection has been ruled out, or exam results are inconclusive or unknown, assign code Z20.828, Contact with and (suspected) exposure to other viral communicable diseases or code Z20.822, Contact with an (suspected) exposure to COVID-19, depending on the encounter date.

    If COVID-19 is confirmed, assign code U07.1 instead of code Z20.828 or Z20.822.

    Annotation: This advice is consistent with the updated ICD-10-CM Official Guidelines for Coding and Reporting that get effective Oct ane, 2020. During these unprecedented times, AHA and AHIMA ended information technology was necessary to clarify the appropriate codes for COVID-19 testing in advance of the effective appointment for the revised official coding guidelines.

  • Assign codes U07.1, COVID-xix, and D68.viii, Other specified coagulation defects.

    If disseminated intravascular coagulation (DIC) is documented, assign lawmaking D65, Disseminated intravascular coagulation [defibrination syndrome], instead of code D68.8. Not all COVID-19 associated coagulopathy professes to DIC.

  • Assign codes U07.1, COVID-19, and D68.8, Other specified coagulation defects, and L99, Other disorders of pare and subcutaneous tissue in diseases classified elsewhere.

  • Viral shedding can mean either that the patient has an agile (current) COVID-19 infection or a personal history of COVID-19. Therefore, the code assignment depends on the provider documentation.

    For documentation of viral shedding in a patient with an agile COVID-19 infection, assign code U07.i, COVID-nineteen.

    For documentation of viral shedding in a patient with a personal history of a COVID-nineteen infection rather than an agile infection, assign code Z86.19, Personal history of other infectious and parasitic diseases, for discharges/encounters prior to January 1, 2021, or code Z86.16, Personal history of COVID-19, for discharges/encounters after January i, 2021.

    If the documentation is not clear as to whether the patient has an agile COVID-xix infection or a personal history, query the provider.

  • [Effective 10/1/21:]

    For discharges/encounters on or afterwards October 1, 2021, assign codes R53.i, Weakness, R63.0, Anorexia, and U09.9, Post COVID-19 condition, unspecified, for a diagnosis of post COVID-19 syndrome with generalized weakness and lack of ambition. This is supported by the instructional note at lawmaking U09.ix to "code first the specific condition related to COVID-19 if known."

    [Prior to 10/i/21:]

    For discharges/encounters prior to Oct ane, 2021, unless the provider specifically documents that the symptoms are the results of COVID-nineteen, assign code(due south) for the specific symptom(due south) and a code for personal history of COVID-19. "Mail COVID-19 syndrome" indicates temporality, merely not that the electric current symptom(s) or clinical condition(s) are a residual effect (sequelae) of COVID-19. Equally stated in the ICD-10-CM Official Guidelines for Coding and Reporting, in the absenteeism of Alphabetic Index guidance for coding syndromes, assign codes for the documented manifestations of the syndrome.

    The appropriate personal history code is Z86.xix, Personal history of other infectious and parasitic diseases, for discharges/encounters prior to Jan ane, 2021, or code Z86.16, Personal history of COVID-19, for discharges/encounters after Jan ane, 2021.

    If the provider documents that the symptoms are the result (residual effect) of COVID-xix, assign code(southward) for the specific symptom(s) and code B94.8, Sequelae of other specified infectious and parasitic diseases. According to the ICD-10-CM Official Guidelines for Coding and Reporting, a sequela is the balance upshot (condition produced) after the acute phase of an illness or injury has terminated.

  • In response to the national emergency that was declared apropos the COVID-19 outbreak, the Centers for Disease Control and Prevention's (CDC) National Center for Health Statistics (NCHS) is implementing new ICD-ten-CM diagnosis codes, effective January one, 2021.

    The new ICD-10-CM codes being implemented on January i, 2021, are:

    J12.82 Pneumonia due to coronavirus affliction 2019

    M35.81 Multisystem inflammatory syndrome

    Z11.52 Meet for screening for COVID-nineteen

    Z20.822 Contact with and (suspected) exposure to COVID-19

    Z86.16 Personal history of COVID-xix

    The Jan 2021 ICD-10-CM Addenda and updated ICD-10-CM Official Guidelines for Coding and Reporting are available at: https://www.cdc.gov/nchs/icd/icd10cm.htm.

  • Assign codes T78.49XA, Other allergy, initial meet; R07.89, Other breast pain; and R09.89, Other specified symptoms and signs involving the circulatory and respiratory systems. The currently approved COVID-19 vaccines in the Usa are not serum based, and therefore lawmaking T80.62XA-, Other serum reaction due to vaccination, initial encounter is not appropriate.

  • Assign codes R53.81, Other malaise; and T50.B95A, Adverse effect of other viral vaccines, initial come across.

  • Assign code T80.52XA, Anaphylactic reaction due to vaccination, initial encounter, for documented anaphylactic reaction to the COVID-19 vaccine. Although subcategory T80.5, identifies anaphylactic reaction to serum, it is the closest available code to capture this status.

  • Yes, it would exist advisable to report a code(s) for side effects when the patient requires additional treatment or medical care such as monitoring or treatment for the side effects. Assign the code for the nature of the upshot (e.g. fever) followed by code T50.B95A, Adverse effect of other viral vaccines, initial come across.

  • Query the provider whether "residual respiratory failure" refers to acute on chronic, or chronic respiratory failure. Assign the appropriate respiratory failure code based on the response, followed past code B94.8, Sequelae of other specified infectious and parasitic diseases, for discharges/encounters prior to October 1, 2021, or code U09.ix, Post COVID-19 condition, unspecified, for discharges/encounters on or after October 1, 2021, every bit a secondary diagnosis, for the sequelae of COVID-19 infection, since the patient has been documented as no longer infectious for COVID-19.

    Although the provider referred to "history of COVID-19," a personal history code is inappropriate in this case. As defined in the ICD-10-CM Official Guidelines for Coding and Reporting, Section IB. "A sequela is the remainder effect (status produced) after the acute phase of an illness or injury has terminated." In addition, Section I. C.21,c,( 4) states "Personal history codes explain a patient'due south past medical condition that no longer exists and is non receiving whatsoever treatment, but that has the potential for recurrence, and therefore may require connected monitoring."

  • Assign code J96.10, Chronic respiratory failure, unspecified whether with hypoxia or hypercapnia, every bit the principal diagnosis since the ARDS has resolved. In addition, assign code B94.viii, Sequelae of other specified infectious and parasitic diseases, for discharges/encounters prior to Oct 1, 2021, or code U09.9, Mail service COVID-19 condition, unspecified, for discharges/encounters on or afterwards October 1, 2021. every bit a secondary diagnosis, since the patient no longer has an active COVID-19 infection.

  • Assign code U07.1. COVID-19, as the master diagnosis. Code J12.82, Pneumonia due to coronavirus disease 2019, would be assigned as an additional diagnosis. The Instructional Note nether code U07.1 directs to use an additional code to place pneumonia or other manifestations. Therefore, when a patient presents with an astute manifestation of COVID-nineteen, such as pneumonia, code U07.1 is sequenced, equally the chief or first diagnosis, regardless of whether the patient'southward most contempo COVID-19 test is positive or negative. The Official Guidelines for Coding and Reporting for sequela land, "A sequela is the residuum effect (status produced) after the astute phase of an affliction or injury has terminated."

  • Assign code U07.i. COVID-19, as the principal or first-listed diagnosis, because the pneumonia is an acute manifestation of the COVID-19 infection. Assign lawmaking J12.82, Pneumonia due to coronavirus disease 2019, as an additional diagnosis. The Instructional Note nether code U07.1 directs to apply an additional code to identify pneumonia or other manifestations. Therefore, when a patient presents with an acute manifestation of COVID-xix, such as pneumonia, lawmaking U07.one should be reported as the principal or get-go diagnosis, regardless of whether the patient's most recent COVID-19 test is positive or negative.

  • Based on the documentation provided, the patient has an organizing pneumonia due to previous COVID-nineteen infection. Assign code J84.89, Other specified interstitial pulmonary diseases, followed by code B94.8. Sequelae of other specified infectious and parasitic diseases, for discharges/encounters prior to Oct 1, 2021, or code U09.9, Mail COVID-nineteen condition, unspecified, for discharges/encounters on or after Oct 1, 2021, for a diagnosis of post COVID-19 organizing pneumonia.

    Code J84.89 may be located by the following Index entry:

    Pneumonia
    - organizing J84.89

  • Assign lawmaking U07.1, COVID-19, as the principal or first-listed diagnosis, considering the pneumonia is an astute manifestation of the COVID-nineteen infection. Assign code J12.82, Pneumonia due to coronavirus disease 2019, and lawmaking J80, Acute respiratory distress syndrome, every bit additional diagnoses for the pneumonia and ARDS. In addition, assign codes J95.859, Other complication of respirator [ventilator], J95.811, Postprocedural pneumothorax, and J94.eight, Other specified pleural conditions, to capture hydropneumothorax barotrauma due to mechanical ventilation. The presence of COVID-19 does not affect lawmaking assignment of hydropneumothorax barotrauma.

  • Assign code Z86.16, Personal history of COVID-19. While the patient had a positive COVID-19 test, the provider documented that the patient was not actively infectious during this access. When the provider documents "noninfectious" or "not infectious" COVID-xix status, this indicates that the patient no longer has an active COVID-19 infection, therefore assign code Z86.sixteen instead of code U07.one, COVID-19.

    Although guideline I.C.1.g.i.a., states: "Code simply a confirmed diagnosis of the 2019 novel coronavirus illness (COVID-19) equally documented by the provider or documentation of a positive COVID-19 examination outcome," in this scenario the provider has clarified the patient no longer has an active COVID-xix infection. Therefore, code U07.1, COVID-xix, is not appropriate and the Official Coding Guideline I.C.1.m.1.a., regarding a positive COVID-xix test result would not apply.

    If the documentation is unclear as to whether the patient has an active COVID-19 infection or a personal history, query the provider for clarification.

  • Although the patient is withal testing positive for COVID-19, the provider has documented the patient'due south condition was a previous history of a COVID-nineteen infection and non a reinfection, therefore it would exist appropriate to assign code Z86.16, Personal history of COVID-19.

  • Assign code U07.1, COVID-19. The provider'due south assessment stated "COVID-19 virus detected," and it is possible for a COVID-19 infection to occur despite vaccination. This is consequent with Official Guidelines for Coding and Reporting, Section I.C.1.g.one.a., which states: Code just a confirmed diagnosis of the 2019 novel coronavirus disease (COVID-19) equally documented by the provider or documentation of a positive COVID-xix exam event.

  • Assign code Z20.822, Contact with and (suspected) exposure to COVID-nineteen, equally primary diagnosis, for a patient admitted and constitute to have a imitation positive COVID-xix test. ICD-10-CM Official Guidelines for Coding and Reporting, Section I.C.ane.chiliad.1.e. states: For asymptomatic individuals with actual or suspected exposure to COVID-19, assign lawmaking Z20.822, Contact with and (suspected) exposure to COVID-19.

    Although guideline I.C.one.thou.ane.a., allows coding of confirmed cases of COVID-19 on the basis of "documentation of a positive COVID-nineteen exam issue," in this scenario the provider clarified the COVID-19 test equally being a faux positive; therefore lawmaking U07.i, COVID-19, is not appropriate and the Official Coding Guideline I.C.1.g.1.a. regarding coding on the basis of a positive COVID-nineteen test result would non apply to this case.

    Withal, it is always appropriate to query the provider for description whenever the coding professional finds the medical record documentation to be unclear regarding the patient's COVID-19 status.

  • No, code Z28.3, Underimmunization condition, is not advisable for this purpose. There is currently no ICD-10-CM lawmaking available to identify lack of immunization confronting COVID-19.

  • In response to the COVID-19 pandemic, the Centers for Medicare and Medicaid Services (CMS) implemented 12 new ICD-x-PCS process codes to describe the introduction or infusion of therapeutics for the treatment of COVID-19, effective with discharges on or after August 1, 2020. The Lawmaking Tables, Alphabetize and related Addenda files for the 12 new procedure codes are available at: https://www.cms.gov/Medicare/Coding/ICD10/2020-ICD-10-PCS.

  • Constructive with discharges on or later August 1, 2020, new ICD-10-PCS codes accept been implemented for the assistants of three unlike drugs when used to treat COVID-19:

    • XW033E5, Introduction of Remdesivir Anti-infective into Peripheral Vein, Percutaneous Approach, New Technology Group five
    • XW043E5, Introduction of Remdesivir Anti-infective into Central Vein, Percutaneous Approach, New Technology Group 5
    • XW033G5, Introduction of Sarilumab into Peripheral Vein, Percutaneous Approach, New Engineering science Group 5
    • XW043G5, Introduction of Sarilumab into Central Vein, Percutaneous Approach, New Technology Group 5
    • XW033H5, Introduction of Tocilizumab into Peripheral Vein, Percutaneous Approach, New Technology Group five
    • XW043H5, Introduction of Tocilizumab into Central Vein, Percutaneous Arroyo, New Engineering Group 5

    These codes should merely exist assigned when these drugs are administered to care for COVID-xix.

  • Effective with discharges on or later on August i, 2020, assign ICD-10-PCS code XW13325, Transfusion of Convalescent Plasma (Nonautologous) into Peripheral Vein, Percutaneous Approach, New Technology Grouping five, or code XW14325, Transfusion of Ambulatory Plasma (Nonautologous) into Central Vein, Percutaneous Approach, New Technology Group 5.

  • Constructive with discharges on or afterward August 1, 2020, the following ICD-10-PCS codes should be used for administration of a new therapeutic substance to treat COVID-19 when the substance is not classified elsewhere in ICD-x-PCS:

    • XW013F5, Introduction of Other New Technology Therapeutic Substance into Subcutaneous Tissue, Percutaneous Approach, New Technology Grouping 5
    • XW033F5, Introduction of Other New Technology Therapeutic Substance into Peripheral Vein, Percutaneous Approach, New Engineering science Group 5
    • XW043F5, Introduction of Other New Applied science Therapeutic Substance into Fundamental Vein, Percutaneous Approach, New Technology Group 5
    • XW0DXF5, Introduction of Other New Technology Therapeutic Substance into Mouth and Throat, External Approach, New Technology Group 5

    These codes should only be assigned for therapeutic substances being used to care for COVID-xix. For administration of "other therapeutic substances" that are being used to treat medical conditions other than COVID-19, see ICD-x-PCS table 3E0. For example, code 3E033GC describes "Introduction of Other Therapeutic Substance into Peripheral Vein, Percutaneous Approach."

  • No, the 12 new ICD-10-PCS codes describing the use of therapeutic substances to treat COVID-19 practice not bear on MS-DRG assignment. However, hospitals are encouraged to report these codes when applicative, as they volition exist useful in evaluating the effectiveness of different therapeutic substances used to treat COVID-19 and for tracking patient outcomes.

  • When a more specific ICD-10-PCS code exists, such as stem cell transfusion, assign that code rather than one of the less specific new technology codes. The new codes for "introduction of other new technology therapeutic substance" are only intended for new substances that are not classified elsewhere in ICD-10-PCS.

  • No, these new codes are only intended for employ when these drugs are being administered to treat COVID-xix.

  • But assign the drug assistants lawmaking once.

  • If your facility wishes to capture this information, you may assign the appropriate code from table 3E0 for introduction of an anti-inflammatory drug. Practise not assign a code from tabular array XW0 for Introduction of Other New Technology Therapeutic Substance.

  • In response to the COVID-19 pandemic, CMS is implementing 21 new ICD-10-PCS procedure codes to describe the introduction or infusion of therapeutics, including monoclonal antibodies, for the treatment of COVID-nineteen, as well as new codes for COVID-19 vaccines, effective Jan one, 2021. An announcement list these codes and data related to the ICD-10 MS-DRGs V38.ane is bachelor at: https://www.cms.gov/medicare/icd-10/2021-icd-x-pcs

    For guidance regarding the appropriate ICD-10-PCS procedure code to assign when a new drug or other therapeutic substance is administered in the hospital inpatient setting to treat COVID-19 and at that place is no unique code for the assistants of the specific substance, see ICD-x-PCS FAQ #iv.

AHA Coding Clinic On-Demand Webinars. American Hospital Association logo.

ICD-10-CM and ICD-10-PCS Coding Handbook 2021 banner. Expert coding training from the source.

For boosted coding guidance for ICD-10-CM for COVID-19 and beyond go to the AHA Coding Clinic Counselor website to see the latest updates.

Related Resources

AHA Eye for Health Innovation Marketplace Browse

It is no accident that so many hospitals and health systems performed at their best nether the worst pandemic conditions. Lessons learned years earlier enabled…

Equally Congress and the Administration continue to talk over potential legislation that would provide additional resources to address the challenges caused past…

AHA, hospital groups ask U.Southward. Department of Health and Man Services Secretary, Xavier Becerra, to renew the COVID-19 public health emergency (PHE).

AHA letter to OSHA requesting a borderline extension for the annotate period reopening of Occupational Safety and Health Administration'due south (OSHA'southward) interim final…

Join AHA's Board Chair Wright Lassiter III for Leadership Dialogue equally he discusses key issues with hospitals colleagues from across the country. Picket the…

Photo Credit: WVU Medicine