Primary Care Coding Alert

Answer: Yes, the CDC, the Centers for Medicare & Medicaid Services (CMS), and the World Health Organization (WHO) have all issued the following guidance for coding both coronavirus diagnoses and testing.

1) For confirmed cases of COVID-19:

Use ICD-10 code U07.1 (2019-nCoV acute respiratory disease). The code becomes effective with the next ICD-10 update on Oct. 1, 2020.

In the interim, the CDC instructs you not to use B34.2 (Coronavirus infection, unspecified) for confirmed cases of COVID-19, “because the cases have universally been respiratory in nature, so the site would not be ‘unspecified.’”

2) For cases when COVID-19 is confirmed as the cause of, or associated with, diseases classified elsewhere:

Use B97.29 (Other coronavirus as the cause of diseases classified elsewhere) as the secondary code in addition to the appropriate code for the other condition. For example, you would assign a patient diagnosed with acute bronchitis due to a confirmed case of COVID-19 with codes J20.8 (Acute bronchitis due to other specified organisms) and B97.29.

3) For suspected and confirmed exposure to COVID-19:

Use Z03.818 (Encounter for observation for suspected exposure to other biological agents ruled out) “for cases where there is a concern about a possible exposure to COVID-19, but this is ruled out after evaluation.”

Use Z20.828 (Contact with and (suspected) exposure to other viral communicable diseases) “for cases where there is an actual exposure to someone who is confirmed to have COVID-19.”

4) For COVID-19 testing:

CDC laboratories may use temporary HCPCS code U0001 “to bill for tests and track new cases of … SARS-CoV-2,” while non-CDC laboratory tests can use U0002 “to bill for SARS-CoV-2/2019-nCoV (COVID-19).”

Medicare claims will be accepted for Tests billed with these codes from dates of service on or after Feb. 4, 2020, beginning on April 1, 2020.

LINKS: CDC ICD-10-CM Official Coding Guidelines – Supplement: www.cdc.gov/nchs/data/icd/ICD-10-CM-Official-Coding-Gudance-Interim-Advice-coronavirus-feb-20-2020.pdf.

CMS Press Release: www.cms.gov/newsroom/press-releases/cms-develops-additional-code-coronavirus-lab-tests.