Pathology/Lab Coding Alert

Watch for pregnancy impact on coding.

You should understand Zika testing after reading “Look Ahead to CDC and Commercial-Lab Zika Testing,” but do you understand how to report relevant Zika diagnosis codes?

If not, read on to learn the best codes for reporting Zika conditions — from exposure to infection. Accurately reporting Zika virus will impact patient treatment, especially for pregnant women.

Look for New, Specific Code

Right now, the best you can do to report a case of confirmed Zika infection is to list A92.8 (Other specified mosquito-borne viral fevers).

But the ICD-10-CM Coordination and Maintenance Committee recently considered a new, more specific code: A92.5 (Zika virus disease). Although the code didn’t make it to the proposed code list for ICD-10 2017, the committee is expecting the code to make it to ICD-10 2017 addenda.

Caution: Don’t start using A92.5 to report positive Zika test results until Oct. 1, 2016 at the earliest, and then only once you know that it’s on the ICD-10 2017 code list. You should be able to find the final list at the Centers for Disease Control and Prevention [CDC] Website beginning Aug. 1.

Pregnancy is different: If the patient diagnosed with a Zika infection is pregnant, you should report O98.51- (Other viral diseases complicating pregnancy...) with the sixth character identifying trimester.

Code for Screening or Symptoms

When you’re reporting a Zika virus screening for asymptomatic patients, you have a couple of code choices. If the patient has no symptoms but meets the epidemiological testing criteria based on travel to a transmission zone, you can report Z11.59 (Encounter for screening for other viral diseases).

When testing an asymptomatic patient who had sexual contact with a person who traveled to a transmission zone and/or shows Zika symptoms, you should report Z20.828 (Contact with and [suspected] exposure to other viral communicable diseases). If the patient has symptoms, you would instead report Z11.3 (Encounter for screening for infections with a predominantly sexual mode of transmission), along with symptom codes.

Special Note: The ICD-10 rule for use of Z20 codes is: “Category Z20 indicates contact with, and suspected exposure to, communicable diseases. These codes are for patients who do not show any sign or symptom of a disease but are suspected to have been exposed to it by close personal contact with an infected individual or are in an area where a disease is epidemic.”

When a patient exhibits Zika symptoms, you should capture the appropriate symptom with code(s) such as the following:

• R50.9 — Fever, unspecified
• R21 — Rash and other nonspecific skin eruption
• M79.1 — Myalgia
• M25.5 — Pain in joint (use code for specific joint when appropriate)
• R51 — Headache
• G61.0 — Guillain-Barre syndrome
• Q02 — Microcephaly

Use one of these codes instead of the Zika diagnosis code if the patient has symptoms, but Zika infection is not confirmed.