Based in U.S., Outsource Strategies International (OSI) have extensive experience in providing accurate medical coding services for clinics, physician groups and hospitals among other providers. Skilled coders at this medical coding company are up to date with the latest coding regulations.

In today’s podcast, Natalie Tornese, one of our Senior Solutions Managers, discusses CDC’s latest guidance on coding and reporting COVID-19.

In This Episode

00:30 Coronavirus Outbreak Summary

Coronavirus is spreading through diverse countries. As of March 2, it is estimated to have caused more than 88000 infections globally.

01:19 CDC Guidance on Coding and Reporting COVID-19

CDC has recent a guidance recently that provides several examples of coding encounters related to coronavirus.

03:11 Related ICD 10 Codes

CDC guidance also discusses certain ICD 10 codes that should be used to report pneumonia, bronchitis, acute lower respiratory infection and Acute respiratory distress syndrome related to COVID-19.

05:24 Coding Signs and Symptoms

Appropriate codes for the signs and symptoms such as cough, fever and shortness of breath are also discussed.

Hello everyone and welcome to our podcast series.I wanted to take this opportunity to talk about a subject that you pretty much can’t get away from- the coronavirus. You look on your TV, on the internet, it’s all you can see. So, let us provide some insight on the coronavirus in relation to coding and billing for this condition.

The coronavirus outbreak continues to sweep across the world.  It is estimated to have caused more than 88000 infections globally as of March 2. In China, where the virus originated, the number of confirmed infections was more than 80,000, with the number of deaths from the virus exceeding 3000at the time of this recording.  In the U.S., a single hospital in Washington State reported two deaths and the total number of cases nationwide spiked 35 percent to 88 on March 2. The CDC has released diagnosis coding guidance for health care encounters and deaths related to COVID-19. It is expected there will be a new ICD-10 code for COVID-19 in the October 1, 2020 ICD-10 revision.

The CDC’s latest guidance is to be used in conjunction with the ICD-10-CM Official Guidelines for Coding and Reporting. The key points of the CDC’s latest guidance on coding encounters related to the 2019 coronavirus outbreak are as follows:

  • Only cases with confirmed symptoms of COVID-19 should be reported with codes explaining the reasons for the encounter. Symptoms can include fever, cough, and shortness of breath, and may appear from 2 to 14 days after exposure.
  • Confirmed COVID-19 infections can cause a range of illnesses, with few or no symptoms. Symptoms can range from mild to severe, and the virus can even cause death.
  • The guidance also explains that diagnosis code B34.2, Coronavirus infection, unspecified, would generally, not be suitable for the COVID-19, as all cases have been respiratory in nature, and so the site would not be “unspecified”.
  • The guidelines also distinguish between ‘possible’ and ‘actual’ exposure to COVID-19: “For cases where there is a concern about a possible exposure, but this is ruled out after evaluation, it would be appropriate to assign the code Z03.818, which is Encounter for observation for suspected exposure to other biological agents ruled out… For an actual exposure to someone who is confirmed to have COVID-19, it would be appropriate to assign the code Z20.828, Contact with and (suspected) exposure to other viral communicable diseases”.

The CDC document provides several examples of coding encounters related to coronavirus, but notes that other codes for conditions unrelated to coronavirus may be fully required. There are certain scenarios,you know for example, pneumonia. Two ICD 10 codes can be used report a case of pneumonia confirmed as due to COVID-19:

  • J12.89, Other viral pneumonia
  • B97.29, Other coronavirus as the cause of disease classified elsewhere

Acute Bronchitis: For a case of acute bronchitis confirmed as due to COVID-19, you would assign the following codes:

  • J20.8 Acute bronchitis due to other specified organisms
  • B97.29 Other coronavirus as the cause of diseases classified elsewhere

To code Bronchitis not otherwise specified (NOS) due to COVID-19, use:

  • J40, Bronchitis, not specified as acute or chronic along with B97.29, Other coronavirus as the cause of diseases classified elsewhere

Lower Respiratory Infection: For COVID-19 documented as due to a lower respiratory infection, not otherwise specified (NOS), or acute respiratory infection, NOS, you would use:

  • J22, Unspecified acute lower respiratory infection, along with code B97.29, Other coronavirus as the cause of diseases classified elsewhere

Assign the following codes if the COVID-19 is documented as being associated with a respiratory infection, NOS:

  • J98.8, Other specified respiratory disorders, and code B97.29, Other coronavirus as the cause of diseases classified elsewhere

ARDS Acute respiratory distress syndrome: For cases with ARDS due to COVID-19 you should assign:

  • J80, Acute respiratory distress syndrome, along with B97.29, Other coronavirus as the cause of diseases classified elsewhere

Code signs and symptoms: If signs and symptoms of COVID-19 are present, but a definitive diagnosis cannot be established, the appropriate codes for the signs and symptoms should be assigned as necessary. For example, a cough would be R05, shortness of breath would be R06.02, and fever would be R50.9.

“Suspected”, “possible” or “probable” COVID-19: If that should ever come to be, the provider would document the condition as “Suspected”, “possible” or “probable”, explaining the reason for the encounter, and you would code that as fever, or Z20.828.

So I hope that this provides some guidance and helps, but always remember that documentation and a thorough knowledge of payer regulations and guidelines is critical to ensure accurate reimbursement for the procedures performed.