Coding for Coronavirus Outbreak: Interim Guidance from the CDC

Coding for Coronavirus Outbreak: Interim Guidance from the CDC

Do you want to learn how to apply the new 2022 ICD-10 COVID-19 codes and the CDC coronavirus coding guidelines? Sign up for our COVID-19 ICD-10 Coding Learning Path and find out how to code Coronavirus infections, symptoms, screening, post-COVID-19 condition, treatments and vaccines. The webinar provides an update to the FY2022 Official Coding Guidelines for COVID-19.

The World Health Organization (WHO) declared the 2019 Novel Coronavirus (COVID-19) disease outbreak a public health emergency of international concern on January 30, 2020 (CDC, 2020). This outbreak of the respiratory disease caused by the novel (new) coronavirus was first detected in Wuhan City, Hubei Province, China. According to the CDC, it 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.

CDC Coronavirus Coding Guidelines

The document, “Announcement New ICD-10-CM Code 2019 Novel Coronavirus (COVID-19),” provides guidance on coding this virus. WHO establishes a new International Classification of Diseases, Tenth Revision (ICD-10) emergency code (U07.1). 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).

The COVID-19 ICD-10 Coding Learning Path provides an overview of the Official Coding and Reporting Guidelines applicable for COVID-19 infections, as well as instructions on how to assign codes for given scenarios involving patient encounters related to COVID-19 infection. See more 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 is “SARS-CoV-2, and the disease it causes is “coronavirus disease 2019” or “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, use the new guidance in conjunction with the current ICD-10-CM classification and the ICD-10-CM Official Guidelines for Coding and Reporting (effective October 1, 2019). The full Supplement is available here. The key Coding Guidance is provided in this article below.

General Guidance

Pneumonia

Confirmed pneumonia as COVID-19: J12.89, Other viral pneumonia, and B97.29, Other Coronavirus as the cause of diseases classified elsewhere.

Bronchitis

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.

Respiratory Infection

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 documentation notes association 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

Important Coding Notes

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).

These CDC Coronavirus coding guidelines were 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.

Do you want to learn how to apply the new COVID-19 coding guidelines 2023? Sign up for our COVID-19 ICD-10 Coding Learning Path and find out how to code Coronavirus infections, symptoms, screening, post-COVID-19 condition, treatments and vaccines. The webinar provides an update to the FY2022 Official Coding Guidelines for COVID-19.