By Jenny Harvey, RHIT, CPHQ, CPMA, CPC, LBMC
Unknown just a few weeks ago, the novel coronavirus named COVID-19 by the World Health Organization (WHO), has now become part of daily life as people across the United States and globe adjust to a ‘new normal.’
The confirmed COVID-19 virus can cause a range of illness, from little-to-no symptoms, to symptoms including fever, cough, and shortness of breath. Based on the incubation period for other coronaviruses, the CDC has determined that symptoms may appear from two to 14 days after exposure.
As this disease becomes more prevalent, it is of great importance that health information and medical coding professionals be proficient in coding COVID-19 to capture the data needed by the CDC to track the progression of this disease. The CDC has offered the following ICD-10-CM coding guidance for coding COVID-19 and/or related symptoms:
- Pneumonia confirmed as due to COVID-19: 89, Other viral pneumonia, and B97.29, Other coronavirus as the cause of diseases classified elsewhere.
- Acute bronchitis confirmed as due to COVID-19: 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: 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.
- Suspected exposure with persons confirmed to have COVID-19: Assign code Z20.828, Contact with and (suspected) exposure to other viral communicable diseases.
- Concern about possible exposure that is ruled out after evaluation: Assign code Z03.818, Encounter for observation for suspected exposure to other biological agents ruled out.
- Testing: There are two new HCPCS codes for healthcare providers who need to test patients for coronavirus. Providers 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). A second new HCPCS code (U0002) can be used by laboratories and healthcare facilities to bill Medicare as well as by other health insurers that choose to adopt this new code for such tests. HCPCS code (U0002) generally describes 2019-nCoV Coronavirus, SARS-CoV-2/2019-nCoV (COVID-19) using any technique, multiple types or subtypes (includes all targets). The Medicare claims processing system will be able to accept these codes on April 1, 2020 for dates of service on or after Feb. 4, 2020.
The CDC’s coding guidance states that coders should not assign code B97.29 when the provider documents “suspected”, “possible” or “probable” COVID-19, but rather assign a code for the reason for the encounter (such as cough, fever, or Z20.828).
It should be noted that the WHO has emergently implemented a new ICD-10-CM code, U07.1 2019-nCoV acute respiratory disease, that will be effective with the next update on Oct. 1, 2020.
CMS has developed a new Healthcare Common Procedure Coding System (HCPCS) code for providers and laboratories who test for COVID-19 using the 2019 Novel Coronavirus Real Time RT-PCR Diagnostic Test Panel. CMS has indicated that the Medicare claims processing system will be able to accept HCPCS code U0001 on April 1, 2020 for dates of service on or after February 4, 2020.
LBMC is monitoring the latest news from the Center for Medicare and Medicaid Services (CMS), the Centers for Disease Control (CDC), the World Health Organization (WHO) and the National Center for Health Statistics (NCHS) in addition to the American Hospital Association (AHA) Coding Clinic for any official coding advice relating to the novel coronavirus.
Jenny Harvey is a manager in the Healthcare Consulting division of LBMC. She holds numerous certification and is an AHIMA-approved ICD-10-CM/PCS trainer. For more information, go to lbmc.com.