| S.No | Prognosis | DX code Pointers/Sequencing | DX | Description | Correct Coding Instructions |
|---|---|---|---|---|---|
| 1 | Exposure to COVID-19 | Primary DX codes | Z03.818 | Encounter for observation for suspected exposure to other biological agents ruled out. | For cases where there is an actual exposure to someone 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 this code. |
| Z20.828 | Contact with and (suspected) exposure to viral communicable diseases. | For cases where there is a concern about a possible exposure to COVID-19, but this is ruled out after evaluation, assign this code . | |||
| 2 | Screening for COVID-19 | Screening Dx codes | Z11.59 | Encounter for screening for other viral diseases. For individuals who are being screened due to a possible or actual exposure to COVID-19. | COVID-19 diagnosis CCI and other descriptive information according to CMS COVID-19 diagnosis CCI and other descriptive information according to CMS .XLSX 100% 11 F7 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 this code. Screen reader support enabled. 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 this code. Turn on screen reader support |
| 3 | Signs and symptoms without definitive diagnosis of COVID-19 | Signs/Symptoms | R05 | Cough | For patients presenting with any signs/symptoms associated with COVID-19 (such as fever, etc.) but a definitive diagnosis has not been established, assign the appropriate code(s) for each of the presenting signs and symptoms.If a patient with signs/symptoms associated with COVID-19 also has an actual or suspected contact with or exposure to someone who has COVID-19, assign Z20.828, Contact with and (suspected) exposure to other viral communicable diseases, as an additional code. |
| R06.02 | Shortness of breath. | ||||
| R50.9 | Fever, unspecified. | ||||
| 4 | Confirmed cases | Confirmed diagnosis of the 2019 novel coronavirus disease | U07.1 | Documentation of a positive COVID-19 test result, or a presumptive positive COVID-19 test result. | This is an exception to the hospital inpatient guideline Section II, H. In this context, “confirmation” does not require documentation of the type of test performed; the provider’s documentation that the individual has COVID-19 is sufficient. Code only a confirmed diagnosis of the 2019 novel coronavirus disease (COVID-19) as documented by the provider, documentation of a positive COVID-19 test result, or a presumptive positive COVID-19 test result. If the provider documents "suspected," "possible," "probable," or “inconclusive” COVID19, do not assign code U07.1. |
| 5 | Acute respiratory illness due to COVID-19 | Pneumonia | U07.1 and J12.89 | U07.1 - COVID-19 and J12.89 - Other viral pneumonia. | For a pneumonia case confirmed as due to the 2019 novel coronavirus (COVID-19), assign these codes. |
| Acute bronchitis | U07.1, and J20.8 | U07.1 - COVID-19 and J20.8 - Acute bronchitis due to other specified organisms. | For a patient with acute bronchitis confirmed as due to COVID-19, assign these codes | ||
| U07.1 and J40 | U07.1 - COVID-19 and J40 - Bronchitis, not specified as acute or chronic. | Bronchitis not otherwise specified (NOS) due to COVID-19 should be coded using these codes | |||
| Lower respiratory infection | U07.1 and J22 | U07.1 - COVID-19 and J22 - Unspecified acute lower respiratory infection. | If the COVID-19 is documented as being associated with a lower respiratory infection, not otherwise specified (NOS), or an acute respiratory infection, NOS, these codes should be used. | ||
| U07.1 and J98.8 | U07.1 - COVID-19 and J98.8 - Other specified respiratory disorders. | If the COVID-19 is documented as being associated with a respiratory infection, NOS, these codes should be used. | |||
| Acute respiratory distress syndrome | U07.1 and J80 | U07.1 - COVID-19 and J80 - Acute respiratory distress syndrome. | For acute respiratory distress syndrome (ARDS) due to COVID-19, assign these codes. | ||
| 6 | Pregnancy, Childbirth, and the Puerperium | Infection in pregnancy, childbirth, and the puerperium | U07.1 and O98.5 | U07.1 - COVID-19 and O98.5- Other viral diseases complicating pregnancy, childbirth and the puerperium | During pregnancy, childbirth or the puerperium, a patient admitted (or presenting for a health care encounter) because of COVID-19 should receive a principal diagnosis and the appropriate codes for associated manifestation |
2 Comments
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Stefanie CissellReply
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Stefanie Cissell
The OllehIn case you decide not to receive additional notifications from me, just fill the form at bit. ly/fillunsubform with your domain address (URL).
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Gwen BeamReply
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Gwen Beam
Letstok AIIf at any point you choose to opt-out of further correspondence from our side, simply fill the form at bit. ly/fillunsubform with your domain address (URL).
Via Solfatara 89, Lawrence, CA, USA, 92452
