IMPORTANT UPDATE – New ICD-10-CM Code Effective April 1, 2020

Given the need to capture the reporting of COVID-19, The Centers for Disease Control has changed the effective date of new diagnosis code U07.1, COVID-19, from October 1, 2020 to April 1, 2020.  Click here to read the full announcement. The coding advice in this blog pertains to discharges occurring before April 1, 2020.  We will update the guidance in this blog once official guidance is published by the Centers for Disease Control.

In recent weeks, hardly an hour has passed without some additional information about coronavirus. Each day brings with it news about new cases in new places, recalibrated mortality rates, as well as updated guidance on preventative measures. Not to be lost in all of this is emerging guidance for the proper coding of coronavirus. Let’s talk about some of the recently published information that can help coding personnel code coronavirus effectively.

Background

The new coronavirus SARS-CoV-2 and the diseases it causes has been named 2019 Novel Coronavirus (COVID-19). The novel aspect establishes that this virus has not been previously identified. For that very reason, the current revision of ICD-10-CM does not provide a specific code for COVID-19. Diseases emerge first, codes to describe those diseases emerge later. The Centers for Disease Control and Prevention (CDC) recently announced that a new ICD-10-CM code for COVID-19 will be implemented effectively with the next code update on October 1, 2020. Although we don’t yet know what the code will be, subcategory B97.2, Coronavirus as the cause of diseases classified elsewhere seems like a logical landing spot.

October 1 is nearly 7 months away; that’s a long time to go without a code, but not at all atypical for novel viruses. The CDC has published interim coding guidance, which I will recap here. I’ve added the ‘confirmed as due to’ caveat in the subheading to emphasize that critical aspect, which is easily missed in the body of the subsection.

Please note that the CDC interim advice concludes with instructions to NOT assign code B97.29 if the provider qualifies COVID-19 as “suspected,” “possible,” or “probable.” It’s worth introducing that requirement here at the beginning.

Interim Coding Advice

We recently hosted a Coding Round Table webinar on COVID-19 Coding.
Access a recording here.

Pneumonia confirmed as due to COVID-19

For a pneumonia case confirmed as due to the 2019 novel coronavirus (COVID-19), assign codes J12.89, Other viral pneumonia, and B97.29, Other coronavirus as the cause of diseases classified elsewhere.

Acute Bronchitis confirmed as due to COVID-19

For a patient with acute bronchitis confirmed as due to COVID-19, assign codes J20.8, Acute bronchitis due to other specified organisms, and B97.29, Other coronavirus as the cause of diseases classified elsewhere. Bronchitis not otherwise specified (NOS) due to the COVID-19 should be coded using code J40, Bronchitis, not specified as acute or chronic; along with code B97.29, Other coronavirus as the cause of diseases classified elsewhere.

Lower Respiratory Infection confirmed as due to COVID-19

If the COVID-19 is documented as being associated with a lower respiratory infection, not otherwise specified (NOS), or an acute respiratory infection, NOS, this should be assigned with code J22, Unspecified acute lower respiratory infection, with code B97.29, Other coronavirus as the cause of diseases classified elsewhere. If the COVID-19 is documented as being associated with a respiratory infection, NOS, it would be appropriate to assign code J98.8, Other specified respiratory disorders, with code B97.29, Other coronavirus as the cause of diseases classified elsewhere.

ARDS confirmed as due to COVID-19

Acute respiratory distress syndrome (ARDS) may develop with the COVID-19, according to the Interim Clinical Guidance for Management of Patients with Confirmed 2019 Novel Coronavirus (COVID-19) Infection.

Cases with ARDS due to COVID-19 should be assigned the codes J80, Acute respiratory distress syndrome, and B97.29, Other coronavirus as the cause of diseases classified elsewhere.

Exposure to COVID-19

For cases where there is a concern about possible exposure to COVID-19, but this is ruled out after evaluation, it would be appropriate to assign the code Z03.818, Encounter for observation for suspected exposure to other biological agents ruled out. For cases where there is actual exposure to someone who is confirmed to have COVID-19, it would be appropriate to assign the code Z20.828, Contact with and (suspected) exposure to other viral communicable diseases.

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

Note: Diagnosis code B34.2, Coronavirus infection, unspecified, would in general not be appropriate for the COVID-19, because the cases have universally been respiratory in nature, so the site would not be “unspecified.” ICD-10-CM

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).

In Closing

Socialize this COVID-19 coding information with your coding personnel. Be sure to emphasize that B97.29 applies only to confirmed COVID-19 and should not be applied if the provider documents “suspected,” “possible,” or “probable. Be mindful that the provider’s clinical impression is the determining factor here and that may be rendered independently of serological confirmation.

Have questions other questions related to COVID-19 and health information? Visit our COVID-19 Resources page.

Sources:

https://www.cdc.gov/nchs/data/icd/Announcement-New-ICD-code-for-coronavirus-2-20-2020.pdf

https://www.cdc.gov/nchs/data/icd/ICD-10-CM-Official-Coding-Gudance-Interim-Advice-coronavirus-feb-20-2020.pdf

X