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