28 Feb CDC Releases ICD-10 Coding Guidance For COVID-19

A new ICD-10-CM code for the particular strain of coronavirus currently causing widespread concern will be presented to the ICD-10 Coordination and Maintenance Committee in March 2020 for inclusion in the ICD-10 classification system in the October 2020 update.

While the current outbreak of the 2019 novel coronavirus (COVID-19) has yet to reach epidemic status in the United States, the CDC has released interim coding guidance in case of further spread:

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
  • R06.02 Shortness of breath
  • R50.9 Fever, unspecified

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

Coding Note: In the outpatient setting if COVID-19 is “suspected,” “possible,” “probable,” or “ruled out,” do not assign B97.29, Other coronavirus as the cause of diseases classified elsewhere. This code should only be used for cases of COVID-19 confirmed by lab testing.

Exposure to COVID-19

For cases where there is a concern about a 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 an 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.

Pneumonia 

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

Acute Bronchitis

For a patient with acute bronchitis confirmed via lab testing 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 confirmed 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

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

Acute respiratory distress syndrome (ARDS) may develop in 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.

Please visit the CDC’s page on COVID-19 and ICD-10-CM updates for more information and news.

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