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CDC Coding Guidelines for COVID-19

Posted by Melissa Cott on May 19, 2020

Use the following CDC Guidelines for assigning ICD-10 to patients with confirmed or suspected COVID-19:

Patients with Confirmed COVID-19 Diagnosis

For patients with a confirmed - not suspected - diagnosis of COVID-19, apply the code U07.1, COVID-19. This applies to patients WITH or WITHOUT symptoms.

Unlike other communicable diseases, 'confirmation' of COVID-19 does not require the type of diagnosis test performed. A physician's documentation that the individual has COVID-19 is sufficient. 

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Patients with Suspected COVID-19 Diagnosis

If the physician documents "suspected," "possible," "probable," or “inconclusive” COVID-19, do not assign code U07.1. Instead, assign a diagnosis code that explains the reason for the provider encounter explaining the reason for encounter (such as fever) or Z20.828, Contact with and (suspected) exposure to other viral communicable diseases.

Additional Diagnoses Caused by COVID-19

If the patient has additional problems resulting from COVID-19 such as pneumonia or bronchitis, code U07.1, COVID-19 first followed by the appropriate codes for associated manifestations (except in the case of obstetrics patients as indicated in Section . I.C.15.s. for COVID-19 in pregnancy, childbirth, and the puerperium).

Pneumonia

If pneumonia is a result of COVID-19, list U07.1, COVID-19 first followed by J12.89, Other viral pneumonia.

Acute bronchitis

If acute bronchitis is due to COVID-19, list U07.1 first followed by J20.8, Acute bronchitis due to other specified organisms. Bronchitis not otherwise specified (NOS) due to COVID-19 should be coded using code U07.1 and J40, Bronchitis, not specified as acute or chronic.

Lower respiratory infection

If COVID-19 is associated with a lower respiratory infection, not otherwise specified (NOS), or an acute respiratory infection, NOS, the CDC recommends codes U07.1 and J22, Unspecified acute lower respiratory infection. If the COVID-19 is documented as being associated with a respiratory infection, NOS, codes U07.1 and J98.8, Other specified respiratory disorders, should be assigned.

Acute respiratory distress syndrome

For acute respiratory distress syndrome (ARDS) due to COVID-19, assign codes U07.1, and J80, Acute respiratory distress syndrome.

Exposure to COVID-19 - Ruled Out

For cases where the patient was suspected to be exposed to COVID-19 but has since been ruled out, assign code Z03.818, Encounter for observation for suspected exposure to other biological agents ruled out. This is a non-PDGM code and can-not be used as a primary ICD on the OASIS assessment if a HIPPS code is required.

Exposure to COVID-19 - Confirmed

For cases where exposure to a person who is confirmed or suspected (not ruled out) to have COVID-19, and the exposed individual either tests negative or the test results are unknown, assign code Z20.828, Contact with and (suspected) exposure to other viral communicable diseases. If the exposed individual tests positive for the COVID-19 virus, see Patients with Confirmed COVID-19 Diagnosis). This is a non-PDGM code and can-not be used as a primary ICD on the OASIS assessment if a HIPPS code is required.

Screening for COVID-19

For asymptomatic individuals who are being screened for COVID-19 and have no known exposure to the virus, and the test results are either unknown or negative, assign code Z11.59, Encounter for screening for other viral diseases. This is a non-PDGM code and can-not be used as a primary ICD on the OASIS assessment if a HIPPS code is required.

Coronavirus Disease 2019 (COVID-19). (n.d.). Retrieved from https://www.cdc.gov/coronavirus/2019-ncov/index.html

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