Reimbursement

CDC Issues ICD-10-CM Coding Guidance for Coronavirus Encounters

The U.S. Centers for Disease Control and Prevention (CDC) issued official guidance to labs and other health care providers on which ICD-10-CM diagnosis codes to use for 2019 novel coronavirus (COVID-19) patient encounters. Specifically, encounters with patients presenting with certain signs and symptoms, but where a definitive diagnosis has not been made, should be coded as follows:

  • R05 – Cough;
  • 02 – Shortness of breath; and
  • 9 – Fever, unspecified

For pneumonia cases confirmed as due to COVID-19: Code J12.89, Other viral pneumonia, and B97.29, Other coronavirus as the cause of diseases classified elsewhere.

For acute bronchitis confirmed as due to COVID-19: Code J20.8, Acute bronchitis due to other specified organisms, or J40, Bronchitis not otherwise specified. In both instances, the provider should also use B97.29.

For lower respiratory infection or acute respiratory infections not otherwise specified that are documented as being associated with COVID-19: Code J22, Unspecified acute lower respiratory infection, with B97.29.

For COVID-19 is documented as being associated with a respiratory infection not otherwise specified: Code J98.8, Other specified respiratory disorders, with code B97.29.

Acute respiratory distress syndrome: Code J80, Acute respiratory distress syndrome, with code B97.29.

For a patient is evaluated following concern of possible exposure to COVID-19, but where COVID-19 is ruled out: Code Z03.818, Encounter for observation for suspected exposure to other biological agents ruled out.

For a patient that has actual exposure to COVID-19: Code Z20.828, Contact with and (suspected) exposure to other viral and communicable diseases.

B97.29 should not be used where the provider documents “suspected,” “possible” or “probable” COVID-19.

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