Coding COVID-2019

Fennemore Craig Client Alert

Coding COVID-2019

The 2019 novel coronavirus (COVID-19) has been dominating the news cycle and new cases are being diagnosed all over the country. While there has been a lot of information about the signs and symptoms to look out for, there has been little information for providers as to how to describe the virus in terms of ICD-10-CM coding. Providers are likely to see an increased number of patients seeking treatment and testing for the signs and symptoms of COVID-19, so they need to know how to code appropriately.

On February 20, 2020, the CDC released revised guidance to help providers appropriately code for COVID-19 cases. Starting April 1, 2020, Code U0001 can be used to denote a new lab test specific to COVID-19. This code should be used for CDC testing laboratories. 

Further, since COVID-19 typically presents within a range of illnesses, the following can be used depending on the accompanying diagnosis:

• Code J20.8 for acute bronchitis due to COVID-19
• Code J40 for bronchitis not otherwise specified (NOS) caused by COVID-19
• Code J22 for lower respiratory infection NOS or acute respiratory infection caused by COVID-19
• Code J98.9 for a respiratory infection NOS caused by COVID-19
• Code J80 for acute respiratory distress syndrome due to COVID-19
• Code Z03.818 for cases where there is concern about possible COVID-19 exposure but exposure is ruled out after evaluation
• Code Z20.828 for actual exposure to a confirmed case of COVID-19
• Code for signs and symptoms associated with COVID-2019:
  • R05 (Cough),
  • R06.02 (Shortness of breath) or
  • R50.9 (Fever, unspecified).  

Providers have also been advised not to use Code B34.2 as it refers to an unspecified corona virus infection whereas COVID-19 has been respiratory in nature. Instead, if a provider suspects a COVID-19 infection, he or she should assign a code that explains the reason for the encounter or concern.

In addition, on March 5, 2020, the Center for Medicare & Medicaid Services (“CMS”) released additional coding information. CMS’s release states that testing Code U0001 should only be used in CDC laboratories and that a second code, Code U0002, should be used in labs using other, non-CDC-created types of tests.

The CDC intends to provide coding further information in its October 1 update, but for now these codes should be used to correctly denote COVID-19 cases. Additional information is available in the CDC’s guidance document, which is available at here.

Providers should continue to monitor the CDC’s COVID-19 page for updates as well. The CDC has guidance on how to protect yourself, common diagnostic information for COVID-19 and more.

Finally, CMS has released guidance on its payment policies relative to COVID-19 which are available as follows:

• Medicare
• Medicaid and Children’s Health Insurance Program
• Individual and Small Group Market Insurance