Coronavirus Medical Coding
What do we need to know about coronavirus medical coding as members of the medical billing community?
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Other Reading Material: Preventing the Coronavirus from Impacting Providers’ Revenue Cycle
Does COVID-19 Have an ICD-10-CM Code?
ICD-10-CM codes can be used to document COVID-19. To learn more, visit www.aapc.com.
Depending on the circumstances, COVID-19 can be coded with B97.29 Other coronaviruses as the cause of diseases classified elsewhere. Only report B97.29 for confirmed cases of COVID-19.
Also, assign the appropriate diagnosis code for a patient with a confirmed condition due to COVID-19. Include code B97.29 for accurately diagnosing viral pneumonia or sepsis caused by a virus.
Utilizing the correct classification code B97.21 is crucial when dealing with a diagnosis of SARS-associated coronavirus. This code reflects that the virus is the underlying cause of the disease, which is classified separately.
To provide the best care, healthcare providers should use code Z20.828 when documenting interactions with patients with viral infectious diseases such as COVID-19. This helps ensure patients receive the proper treatment.
The CDC explains that B34.2 Coronavirus infection, unspecified, is inappropriate because the coronavirus is a respiratory illness and, therefore, the site is not unknown.
More recently, WHO released emergency use ICD codes for 2019-nCoV. The WHO has declared the ‘2019-nCoV’ outbreak a global public health emergency.
ICD-10 code U07.1 is used to diagnose 2019-nCoV acute respiratory disease in emergencies.
The ICD-11 code for the illness is RA01.0. Note that the disease name 2019-nCoV may change to be independent of date and virus family. At the time of this post, the Centers for Medicare & Medicaid Services had not released any instructions for using these new codes.
UPDATE 3/27/2020 Consistent with these WHO updates to the ICD-10, the CDC will implement U07.1 COVID-19 into ICD-10-CM for reporting, effective with the next update, April 1, 2020.
Does COVID-19 Have a Test Code?
According to a Centers for Medicare & Medicaid Services (CMS) press release, “Healthcare providers who need to test patients for Coronavirus using the Centers for Disease Control and Prevention (CDC) 2019 Novel Coronavirus Real-Time RT-PCR Diagnostic Test Panel may bill for that test using the newly created HCPCS code (U0001).” This code is tailored explicitly to conduct SARS-CoV-2 tests on patients within CDC laboratories.
UPDATE 3/6/2020
CMS has developed a second HCPCS Level II code (U0002) for labs to bill for non-CDC lab tests for SARS-CoV-2/2019-nCoV (COVID-19). As per the latest policy issued by the Food and Drug Administration in February, it is now permissible for specific laboratories to utilize the code for the tests they have developed.
You must provide the correct code for testing when you submit Medicare claims from April 1, 2020. This is mandatory, and your lawsuit will be denied if you don’t do it. Medicare contractors will set the payment amount for these new codes until CMS sets national payment rates.
UPDATE 3/13/2020 The CPT Editorial Panel has approved a new CPT® code for COVID-19 testing.