COVID-19 ICD-10-CM Effective April 1
On 3/18/20, the Centers for Disease Control and Prevention (CDC) announced that the effective date of a new diagnosis code U07.1, COVID-19, from October 1, 2020 to April 1, 2020. According to the CDC, “this off-cycle update is unprecedented and is an exception to the code set updating process established under HIPAA,” citing sections 201 and 301 of the National Emergencies Act.
Below is a table of the ICD-10-CM interim coding guidance. This guidance can be found here.
2019 Novel Coronavirus (COVID-19) Interim Coding Advice
|Disease/Condition due to COVID-19||ICD-10 Code||Description|
|COVID-19||U07.1||COVID-19 Emergency ICD-10 code|
|Pneumonia||J12.89 with||Other viral pneumonia|
|B97.29||*Other coronavirus as the cause of diseases classified elsewhere|
|Acute Bronchitis||J20.8 with B97.29*||Acute bronchitis due to other specified organisms|
|Bronchitis not otherwise specified (NOS)||J40 with B97.29*||Bronchitis, not specified as acute or chronic|
|Lower Respiratory Infection||J22 with B97.29*||Unspecified acute lower respiratory infection|
|Respiratory Infection NOS||J98.8 with B97.29*||Respiratory infection, NOS|
|Adult Respiratory Distress Syndrome (ARDS)||J80 with B97.29*||Acute respiratory distress syndrome|
|Possible Exposure but ruled out||Z03.818||Encounter for observation for suspected exposure to other biological agents ruled out|
|Actual exposure||Z20.828||Contact with and (suspected) exposure to other viral communicable diseases|
Additional COVID-19 Coding Notes
- Diagnosis code B34.2, Coronavirus infection, unspecified, would generally not be appropriate for the COVID-19, because the cases have universally been respiratory in nature, so the site would not be “unspecified.”
- If the provider documents “suspected”, “possible” or “probable” COVID-19, do not assign code B97.29. Assign a code(s) explaining the reason for encounter (such as fever, or Z20.828).
- Section I coding requirements must still be met:
- Active Diagnoses – Physician-documented diagnoses in the last 60 days that have a direct relationship to the resident’s current functional status, cognitive status, mood or behavior, medical treatments, nursing monitoring, or risk of death during the 7-day look-back period.
- ICD-10 Codes for Signs and symptoms – For patients presenting with any signs/symptoms (such as fever, etc.) and where a definitive diagnosis has not been established, assign the appropriate code(s) for each of the presenting signs and symptoms such as:
- R05 Cough
- 02 Shortness of breath
- 9 Fever, unspecified