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How to Code the New ICD-10-CM Code for COVID-19

April 10, 2020
Documentation, Billing, & Coding By Terry Raser, Senior Consultant

Per the Centers for Disease and Control, ICD-10-CM code U07.1, COVID-19, may be used for discharges and dates of service on or after April 1, 2020.

Coding_ICD-10-CM_COVID-19

 

The code was developed by the World Health Organization and is intended to be sequenced first, followed by the appropriate codes for associated manifestations when COVID-19 meets the definition of principal or first-listed diagnosis. For guidance prior to April 1, 2020, please refer to the supplement to the ICD-10-CM Official Guidelines for coding encounters related to the COVID-19 coronavirus outbreak:

ICD-10-CM Official Coding Guidelines—Supplement Coding encounters related to COVID-19 Coronavirus Outbreak Effective February 20, 2020:

https://www.cdc.gov/nchs/data/icd/ICD-10-CM-Official-Coding-Gudance-Interim-Advice-coronavirus-feb-20-2020.pdf

Frequently Asked Questions and Answers for ICD-10-CM coding for COVID-19:

https://www.aha.org/fact-sheets/2020-03-30-frequently-asked-questions-regarding-icd-10-cm-coding-covid-19

As of April 1, 2020, COVID-19 meets the definition of principal or first-listed diagnosis, code U07.1, COVID-19, and should be sequenced first, then followed by the appropriate codes for associated manifestations, except in the case of newborns and obstetrics patients. See chart below:

COVID_ICD_10_Coding


Remember, the definition of “Excludes 1” means you cannot code them together.

The new COVID-19 code for the Patient-Driven Payment Model maps to the pulmonary category mapping of the “medical management” category for the PT/OT component. The Centers for Medicare & Medicaid Services (CMS) updated the ICD-10-CM mapping on 3/31/2020. Here is the link: https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/SNFPPS/PDPM. To our knowledge, CMS is not changing the guidance to coding isolation infection.

For education on ICD-10-CM coding, contact Terry Raser, Senior Consultant by calling 484-365-2680 or email TRaser@LW-Consult.com.

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