End of the COVID-19 PHE Prompts Coding Guideline Change for October 1, 2023
On January 30, 2023, the White House announced that the declaration of national emergency, as well as the COVID-19 public health emergency (PHE) declaration, would both end on May 11, 2023. These declarations were initially declared in early 2020, and the January 30, 2023 announcement allows for more than 60 days’ notice before termination of the PHE as previously committed to by the Administration.
While many adjustments were prompted by the official end of the PHE, one in particular is directly related to ICD-10-CM coding, screening for COVID-19, coded as Z11.52. Official Coding Guidelines state that the screening code cannot be used during a pandemic. The switch to Z11.52 is effective on October 1, 2023, which has been confirmed in the AHA’s COVID-19 FAQ document (see ICD-10-CM Questions #64 and #65).
See guideline I.C.1.g,1) (f), which reads:
(f) Screening for COVID-19
During the COVID-19 pandemic, a screening code is generally not appropriate. Do not assign code Z11.52, Encounter for screening for COVID-19. For encounters for COVID-19 testing, including preoperative testing, code as exposure to COVID-19 (guideline I.C.1.g.1.e).
Coding guidance will be updated as new information concerning any changes in the pandemic status becomes available.
Due to the official end of the COVID-19 pandemic PHE, this guideline will change as of October 1, 2023. This was announced by the AHA during the March 7, 2023, Coordination and Maintenance meeting and published in the First Quarter 2023 Coding Clinic:
“As a result of the COVID-19 Public Health Emergency ending on May 11, 2023, the FY24 ICD-10-CM Official Guidelines for Coding and Reporting will be revised to state that code Z11.52, Encounter for screening for COVID-19, should be assigned for encounters for screening for COVID-19 infection. This guideline change will become effective October 1, 2023.”