Coding for Coronavirus Outbreak: Interim Guidance from the CDC
On January 30, 2020, the World Health Organization (WHO) declared the 2019 Novel Coronavirus (COVID-19) disease outbreak a public health emergency of international concern (CDC, 2020). This outbreak of the respiratory disease caused by the novel (new) coronavirus was first detected in Wuhan City, Hubei Province, China. It has rapidly spread, and, according to the CDC, has been detected in 37 locations internationally, including cases in the United States. “The virus has been named ‘SARS-CoV-2,’ and the disease it causes has been named ‘coronavirus disease 2019’ (abbreviated ‘COVID-19’),” reports the CDC (2020).
The term “Coronaviruses” refers to a large group of viruses that are commonly seen in “many different species of animals, such as camels, cattle, cats, and bats” (The Bottom Line, 2020). It is rare that these animal coronaviruses infect people and then spread between people, but it does happen as with MERS, SARS, and now with COVID-19 (CDC, 2020).
Coronavirus is Not New
According to the World Health Organization, “Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases such as Middle East Respiratory Syndrome (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS-CoV). A novel coronavirus (nCoV) is a new strain that has not been previously identified in humans” (WHO, 2020).
These Coronaviruses were originally transmitted between animals and people and are termed “zoonotic.” It is important to understand that there is a difference between previous strains of Coronavirus and the new COVID-19.
Click here for a PDF file on various types of Coronavirus.
Coding for COVID-19
As a result of the public health emergency, the document, “Announcement New ICD-10-CM Code 2019 Novel Coronavirus (COVID-19),” was released to provide guidance on coding this virus. A new International Classification of Diseases, Tenth Revision (ICD-10) emergency code (U07.1), has been established by WHO. The ICD-11 code would be RA01.0. The title of U07 will be changed back to “codes for emergency use” (WHO, 2019).
For consistency, the Centers for Disease Control and Prevention’s National Center for Health Statistics (CDC/NCHS) will also include a new diagnosis code into the ICD-10-CM effective with the next update, October 1, 2020. The complete addenda change, and new code and final title will be presented at the March 2020 ICD10 Coordination and Maintenance Committee meeting (CDC/NCHS, 2020).
Review this document here.
ICD-10-CM Official Coding Guidelines – Supplement
Further, in the interim, the ICD-10-CM Official Coding Guideline – Supplement for 2019 Novel Coronavirus (COVID-19) was also posted here. This Official Coding Guideline Supplement is effective February 20, 2020.
Note: Remember that this novel virus has been named “SARS-CoV-2, the disease it causes is named “coronavirus disease 2019” and abbreviated “COVID-19.” There is also documentation of 2019-nCoV in literature. This is important because it is likely that you will see this documented a number of ways. Going forward, it appears that the correct method is COVID-19.
As with other Supplements, the new guidance is to be used in conjunction with the current ICD-10-CM classification and the ICD-10-CM Official Guidelines for Coding and Reporting (effective October 1, 2019). Updates will be added when available. The full Supplement is available here. The key Coding Guidance is provided in this article below.
Confirmed pneumonia as COVID-19: J12.89, Other viral pneumonia, and B97.29, Other Coronavirus as the cause of diseases classified elsewhere.
Confirmed acute bronchitis as COVID-19: J20.8, Acute bronchitis due to other specified organisms, and B97.29, Other Coronavirus as the cause of diseases classified elsewhere. Bronchitis NOS due to COVID-19: J40, Bronchitis, not specified as acute or chronic, and B97.29, Other Coronavirus as the cause of diseases classified elsewhere.
COVID-19 associated with a lower respiratory infection, NOS, or an acute respiratory infection, NOS: J22, Unspecified acute lower respiratory infection, and B97.29, Other Coronavirus as the cause of diseases classified elsewhere.
If the COVID-19 is documented as being associated with a respiratory infection, NOS: J98.8, Other specified respiratory disorders, and B97.29, Other Coronavirus as the cause of diseases classified elsewhere.
Acute Respiratory Distress Syndrome (ARDS)
ARDS due to COVID-19: J80, Acute respiratory distress syndrome, and B97.29, Other Coronavirus as the cause of diseases classified elsewhere.
Exposure to COVID-19
Concern about possible exposure to COVID-19, ruled out: Z03.818, Encounter for observation for suspected exposure to other biological agents ruled out.
Actual exposure to someone confirmed to have COVID-19: Z20.828, Contact with and (suspected) exposure to other viral communicable diseases.
Signs and Symptoms
Definitive diagnosis not established, patient presenting with signs/symptoms: Assign appropriate code(s) for each of the presenting signs and symptoms such as:
• R05 Cough • R06.02 Shortness of breath • R50.9 Fever, unspecified
Note: Diagnosis code B34.2, Coronavirus infection, unspecified, would generally not be appropriate for the COVID-19, because the cases have universally been respiratory in nature, so the site would not be “unspecified” (CDC/NCHS, 2020).
If the provider documents “suspected,” “possible,” or “probable” COVID-19, do not assign code B97.29. Assign a code(s) explaining the reason for encounter, such as fever, or Z20.828 (CDC/NCHS, 2020).
This coding guidance has been developed by CDC and approved by the four organizations that make up the Cooperating Parties: the National Center for Health Statistics, the American Health Information Management Association, the American Hospital Association, and the Centers for Medicare & Medicaid Services (CDC/NCHS, 2020).
To read about the other latest ICD-10-CM code, U07.0 – Vaping-related disorder, review our previous article.