Elsevier Coding Updates



COVID-19 Coding UpdateWith the United States declaring a national emergency in early March, as well as the World Health Organization (WHO) proclaiming the 2019 novel coronavirus, COVID-19, a pandemic, The Centers for Disease Control (CDC), announced an immediate change in the effective date for a unique diagnosis code, U07.1, developed by WHO, in order to definitively identify COVID-19, with the implementation date moved up from October 1, 2020, to April 1, 2020. This unprecedented off-cycle update became urgent due to the outbreak that quickly became a public health emergency of international concern in order to specifically identify COVID-19, since other types of coronavirus infection exist. It is important to note that the new ICD-10-CM code, U07.1, COVID-19, may only be reported for services or discharges on or after April 1, 2020. The new code is not retroactive for cases treated or discharged up to and including March 31, 2020. The 2020 ICD-10-CM Official Guidelines for Coding and Reporting provide directions for reporting diagnoses related to the COVID-19 outbreak for services or discharges prior to April 1, 2020. ICD-10-CM coding guidance for COVID-19 up to and including March 31, 2020:Pneumonia – Pneumonia confirmed as due to COVID-19, assign codes J12.89, other viral pneumonia, and B97.29, Other coronavirus as the cause of diseases classified elsewhere.Acute Bronchitis – Acute bronchitis confirmed as due to COVID-19, assign codes J20.8, Acute bronchitis due to other specified organisms, and B97.29, Other coronavirus as the cause of diseases classified elsewhere. Bronchitis NOS – Bronchitis not otherwise specified (NOS) due to COVID-19 should be coded using J40, Bronchitis, not specified as acute or chronic; and B97.29, Other coronavirus as the cause of diseases classified elsewhere.Lower Respiratory Infection – If COVID-19 is documented as being associated with a lower respiratory infection not otherwise specified (NOS), or acute respiratory infection NOS, code J22, Unspecified acute lower respiratory infection, should be assigned along with code B97.29, Other coronavirus as the cause of diseases classified elsewhere. Respiratory Infection NOS – If COVID-19 is documented as being associated with a respiratory infection not otherwise specified, assign code J98.8, Other specified respiratory disorders, with code B97.29, Other coronavirus as the cause of diseases classified elsewhere. ARDS – Acute respiratory distress syndrome (ARDS) due to COVID-19 should be assigned codes J80, Acute respiratory distress syndrome, and B97.29, Other coronavirus as the cause of diseases classified elsewhere. Exposure – For cases where there is concern about possible exposure to COVID-19 but ruled out after evaluation, the appropriate code assignment would be Z03.818, Encounter for observation for suspected exposure to other biological agents ruled out. For cases where there is an actual exposure to someone confirmed to have COVID-19, the appropriate code assignment would be Z03.828, Contact with and (suspected) exposure to other viral communicable diseases.Signs & Symptoms – For patients presenting with any signs/symptoms (such as fever, etc.) and where a definitive diagnosis for COVID-19 has not been established, assign code(s) for each of the presenting signs and symptoms:R05 – CoughR06.02 – Shortness of breathR50.9 – Fever, unspecifiedICD-10-CM coding guidance for COVID-19 on or after April 1, 2020:U07.1, COVID-19, appears as a new code in the ICD-10-CM Tabular List of Diseases and Injuries, April 1, 2020, Addenda, New Chapter 22, where codes for special purposes (U00-U85) have been added. A new section for Provisional assignment of new diseases of uncertain etiology or emergency, has been established with codes U00-U49. New category U07, conditions of uncertain etiology, is listed along with additional subcategories U07.0, Vaping-related disorder, and U07.1, COVID-19.Subcategory code U07.1, COVID-19, provides guidance with directing the use of additional codes to identify pneumonia or other manifestations. Excludes 1 notes specifically exclude coronavirus infection unspecified (B34.2), Coronavirus as the cause of disease classified elsewhere (B97.2-), and Pneumonia due to SARS-associated coronavirus (J12.81). COVID-19 infections can manifest in a broad range of issues, from patients presenting with little or no symptoms to those presenting with serious illness or terminal. Symptoms include fever, cough, and shortness of breath and may appear from 2 – 14 days after exposure, as seen in incubation periods for other coronaviruses from past-history. According to the Guidelines, a copy of the positive test result is not required for a COVID-19 case to be considered “confirmed”, as the provider’s diagnostic statement that the patient has the condition is sufficient in order to establish a confirmed diagnosis.Beginning April 1, 2020, when COVID-19 meets the definition of principal diagnosis, code U07.1, COVID-19 should be sequenced first, followed by the appropriate codes for associated manifestations. Pneumonia – Codes U07.1, COVID-19, and J12.89, other viral pneumoniaAcute bronchitis – Codes U07.1, COVID-19, and J20.8, acute bronchitis due to other specified organismsBronchitis not otherwise specified (NOS) – Code U07.1, COVID-19, and J40, bronchitis, not specified as acute or chronicLower respiratory infection NOS – U07.1, COVID-19, and J22, unspecified acute lower respiratory infectionAcute respiratory infection NOS – U07.1, COVID-19, and J22, unspecified acute lower respiratory infectionRespiratory infection NOS – U07.1, COVID-19, and J98.8, other specified respiratory disordersAcute respiratory distress syndrome – U07.1, COVID-19, and J80, acute respiratory distress syndromeThe ICD-10-CM Official Coding and Reporting Guidelines for coding COVID-19 may be found at information regarding ICD-10-CM coding guidance may be found at and American Medical Association (AMA) has announced a new CPT code, 87635, in order to report this novel coronavirus, COVID-19, laboratory test. This new code will track testing services and simplify reporting, reimbursement, and resource planning for the number of novel coronavirus confirmed or suspected cases. The description for CPT 87635 includes the official name of the virus, Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2), as assigned by the World Health Organization, while the name of the disease it causes is the 2019 coronavirus disease (COVID-19). CPT code 87635 describes: Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]), amplified probe technique.The code is effective immediately for use as the industry test standard in order to report testing for the novel coronavirus, COVID-19. Additional information regarding CPT code 87635 reporting can be found on the AMA website: ama- For Medicare claims, the Centers for Medicare and Medicaid Services (CMS) has established 2 new HCPCS Level II codes specifically for coronavirus testing. HCPCS code U0001 is reported by CDC testing laboratories who test patients for SARS-CoV-2 and track COVID-19 cases. HCPCS code U0002 is reported for non-CDC laboratory tests for SARS-CoV-2/2019-nCoV(COVID-19), which allows certain approved laboratories who have developed their own validated COVID-19 diagnostic tests to report these tests and assist in tracking COVID-19 patients. Additional information regarding these codes may be found on the CMS website at ................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download