Revenue Cycle Insider

Question: What is long COVID, how is it coded, and how does that differ from active COVID?

Wyoming Subscriber

Answer: According to the Centers for Disease Control and Prevention (CDC), long COVID is “a chronic condition that occurs after SARS-CoV-2 infection and is present for at least 3 months.” Among its many symptoms are fatigue, fever, difficulty breathing, coughing, and changes in smell or taste. The CDC notes that “there is no laboratory test that can determine if ... symptoms or conditions are due to Long COVID,” and “a positive SARS-CoV-2 test is not required for a Long COVID diagnosis.” This means a clinical evaluation from your provider will be necessary before you can assign a definitive diagnosis code.

To report long COVID, you’ll follow ICD-10-CM Guideline I.C.1.g.1.m (Post COVID-19 Condition), which instructs you to use one or more codes “for the specific symptom(s) or condition(s) related to the previous COVID-19 infection, if known” and U09.9 (Post COVID-19 condition, unspecified). Per Centers for Medicare & Medicaid Services (CMS) guidance, long COVID is regarded as a post COVID-19 condition. The ICD-10-CM guideline also tells you that “U09.9 should not be assigned for manifestations of an active (current) COVID-19 infection,” which should be coded with U07.1 (COVID-19).

So, if a patient presents with a cough, loss of smell and/or taste, difficulty breathing, and fever, and your provider determines these symptoms are due to long COVID, you’ll report signs and symptoms codes such as R05.1 (Acute cough) or R05.9 (Cough, unspecified), R06.02 (Shortness of breath), R50.9 (Fever, unspecified), and R43.8 (Other disturbances of smell and taste) along with U09.9.

Bruce Pegg, BA, MA, CPC, CFPC, Managing Editor, AAPC