ICD 10 Coding Alert

U.S. experts believe that it’s just a matter of time until we are encountering COVID-19 in our own communities. The virus, SARS-CoV-2, emerged in late 2019 in China and is now present on every continent except Antarctica.

“No deaths occurred in the group aged 9 years and younger, but cases in those aged 70 to 79 years had an 8.0% [case-fatality rate] CFR and cases in those aged 80 years and older had a 14.8% CFR,” say Zunyou Wu, MD, PhD, and Jennifer M. McGoogan, PhD, researchers at the Chinese Center for Disease Control and Prevention in Beijing, China, in a late-February JAMA article.

There is an outbreak of COVID-19 in Washington, and a nursing home has had several residents die of the disease. Several staff members have become sick as well. Other states are seeing clusters of infections, too.

“We expect we will see community spread … It’s not a question of if this will happen anymore but rather a question of exactly when this will happen and how many people in this country will have severe illness,” says Nancy Messonnier, MD, director of the National Center for Immunization and Respiratory Diseases in Atlanta.

“The confirmed COVID-19 infections can cause a range of illness, from little to no symptoms, to those affected being severely ill and even dying. Symptoms can include fever, cough, and shortness of breath. Symptoms may appear from 2 to 14 days after exposure, based on the incubation period for other coronaviruses, such as the MERS (Middle East Respiratory Syndrome) viruses,” says the Centers for Disease Control and Prevention (CDC) in a dedicated COVID-19 fact sheet.

Check Out these Dedicated ICD-10 Codes

Depending on the circumstances, you can code COVID-19 with B34.2 (Coronavirus infection, unspecified) or, if the coronavirus has been identified as the organism responsible for other conditions, B97.29 (Other coronavirus as the cause of diseases classified elsewhere).

Per ICD-10-CM guidelines, use B97.29 as an additional code if the virus is responsible for such diseases as pneumonia, classified as J12.89 (Other viral pneumonia), or sepsis, classified as A41.89 (Other specified sepsis).

If the patient has bronchitis due to COVID-19, use code J40 (Bronchitis, not specified as acute or chronic), along with code B97.29, (Other coronavirus as the cause of diseases classified elsewhere).

Should your provider determine that a patient is infected with coronavirus associated with SARS, use B97.21 (SARS-associated coronavirus as the cause of diseases classified elsewhere).

Patients with COVID-19 may also develop acute respiratory distress syndrome (ARDS), in which case you should choose J80 (Acute respiratory distress syndrome), and B97.29 (Other coronavirus as the cause of diseases classified elsewhere).

Use Z20.828 (Contact with and (suspected) exposure to other viral communicable diseases) to document an encounter with a patient infected with any form of the virus and Z03.818 (Encounter for observation for suspected exposure to other biological agents ruled out) if the patient may have been exposed to COVID-19 but that the provider rules out that possibility after evaluation.

Coding tip: “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),” CDC says.

Remember, the status of COVID-19 disease changes daily, so check the CDC’s website for up-to-date details, here: www.cdc.gov/coronavirus/2019-ncov/index.html.