Medical Codes to Report COVID-19 (2019 Novel Coronavirus)

by | Last updated Jun 1, 2023 | Published on Mar 6, 2020 | Medical Coding

Medical Codes to Report COVID 19
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More and more countries are facing the impact of the 2019 Novel Coronavirus (COVID-19). In the U.S., the second coronavirus death was recently confirmed in Washington State. The first case was confirmed earlier in New York. Hospitals and Emergency departments are also getting busy treating infected patients. U.S. hospitals are getting prepared for this threat by stocking up gowns and goggles and holding refresher courses in infection control. At the same time, medical coding companies are providing the necessary support to hospitals to code for the new outbreak on medical claims and submit them on time.

Medical Codes for Reporting Coronavirus

Codes in the current 2020 ICD-10-CM code set

Even though the corona infection is new, there are certain ICD-10 codes in the current set that could be used to document COVID-19.

Depending on the circumstances, confirmed cases of COVID-19 can be coded using

  • B97.29 Other coronavirus as the cause of diseases classified elsewhere

Based on ICD-10-CM coding guidelines, B97.29 should be used as an additional code if the virus is responsible for such diseases as pneumonia, classified as –

  • J12.89 Other viral pneumonia or
  • A41.89 Other specified sepsis

For coronavirus infection associated with SARS, use

  • B97.21 SARS-associated coronavirus as the cause of diseases classified elsewhere

To report an encounter with a patient infected with any form of the virus, coders can use

  • Z20.828 Contact with and (suspected) exposure to other viral communicable diseases

New ICD-10 Code for COVID-19

After the declaration of CoronaVirus (CoV) Outbreak as a Global Emergency in January 2020, in an emergency meeting the World Health Organization (WHO) established an emergency ICD-10 code for COVID-19, which is “U07.1”, 2019-nCoV acute respiratory disease.

The ICD-11 code recommend for this respiratory illness is “RA01.0”. At the time of this post, the Centers for Medicare & Medicaid Services had not released any instructions for the use of these new codes.

New HCPCS code

In its press release, CMS announced the release of a new Healthcare Common Procedure Coding System (HCPCS) code for providers and laboratories to test patients for SARS-CoV-2, which is “U0001”.

Providers and laboratories conducting 2019 Novel Coronavirus Real Time RT-PCR Diagnostic Test Panel can bill using this specific code, instead of using an unspecified code. CMS has highlighted that the Medicare claims processing system will be able to accept this code on April 1, 2020 for dates of service on or after February 4, 2020.

According to an article in itn (IMAGING TECHNOLOGY NEWS) online, a study led by Central South University in Hunan Province, published in an online version of Radiology has proven that CT imaging was able to identify coronavirus before some patients tested positive in laboratory tests. Of the 167 patients evaluated for the study, 3% initially had negative RT-PCR, but had positive chest CT with a pattern consistent with viral pneumonia. After positive CT findings, all patients were isolated for presumed 2019-nCoV pneumonia. The authors of the study stated that RT-PCR testing for this viral infection may be falsely negative, because of the laboratory errors or due to insufficient viral material in the specimen. They concluded that the CT features of viral pneumonia may be strongly suspicious for 2019-nCoV infection, even if the RT-PCR results are negative. In such cases, repeat swab testing and patient isolation should be considered.

For any diagnostic tests done and treatment provided, medical codes are now available. Providers can rely on professional medical billing and coding services to get their medical claims submitted without delay.

Rajeev Rajagopal

Rajeev Rajagopal, the President of OSI, has a wealth of experience as a healthcare business consultant in the United States. He has a keen understanding of current medical billing and coding standards.

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