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Resource COVID Guidelines

Here are some free helpful resources for COVID coding.

See the ICD-10-CM guidelines.

Access AMA CPT coding tools.

g. Coronavirus infections
1) COVID-19 infection (infection due to SARS-CoV-2)
(a) Code only confirmed cases
Code only a confirmed diagnosis of the 2019 novel coronavirus
disease (COVID-19) as documented by the provider, or
documentation of a positive COVID-19 test result. For a
confirmed diagnosis, assign code U07.1, COVID-19. This is an
exception to the hospital inpatient guideline Section II, H. In this
context, “confirmation” does not require documentation of a
positive test result for COVID-19; the provider’s documentation
that the individual has COVID-19 is sufficient.
If the provider documents "suspected," "possible," "probable," or
“inconclusive” COVID-19, do not assign code U07.1. Instead,
code the signs and symptoms reported. See guideline I.C.1.g.1.g.
(b) Sequencing of codes
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, except when
another guideline requires that certain codes be sequenced first,
such as obstetrics, sepsis, or transplant complications.
For a COVID-19 infection that progresses to sepsis, see Section
I.C.1.d. Sepsis, Severe Sepsis, and Septic Shock
See Section I.C.15.s. for COVID-19 infection in pregnancy,
childbirth, and the puerperium
See Section I.C.16.h. for COVID-19 infection in newborn
For a COVID-19 infection in a lung transplant patient, see
Section I.C.19.g.3.a. Transplant complications other than
kidney.
(c) Acute respiratory manifestations of COVID-19
When the reason for the encounter/admission is a respiratory
manifestation of COVID-19, assign code U07.1, COVID-19, as
the principal/first-listed diagnosis and assign code(s) for the
respiratory manifestation(s) as additional diagnoses.
The following conditions are examples of common respiratory
manifestations of COVID-19.
(i) Pneumonia
ICD-10-CM Official Guidelines for Coding andReporting
FY 2022
Page 28 of 115
For a patient with pneumonia confirmed as due to
COVID-19, assign codes U07.1, COVID-19, and J12.82,
Pneumonia due to coronavirus disease 2019.
(ii) Acute bronchitis
For a patient with acute bronchitis confirmed as due to
COVID-19, assign codes U07.1, and J20.8, Acute
bronchitis due to other specified organisms.
Bronchitis not otherwise specified (NOS) due to COVID19 should be coded using code U07.1 and J40, Bronchitis,
not specified as acute or chronic.
(iii)Lower respiratory infection
If the COVID-19 is documented as being associated with
a lower respiratory infection, not otherwise specified
(NOS), or an acute respiratory infection, NOS, codes
U07.1 and J22, Unspecified acute lower respiratory
infection, should be assigned.
If the COVID-19 is documented as being associated with
a respiratory infection, NOS, codes U07.1 and J98.8,
Other specified respiratory disorders, should be assigned.
(iv)Acute respiratory distress syndrome
For acute respiratory distress syndrome (ARDS) due to
COVID-19, assign codes U07.1, and J80, Acute
respiratory distress syndrome.
(v) Acute respiratory failure
For acute respiratory failure due to COVID-19, assign
code U07.1, and code J96.0-, Acute respiratory failure.
(d) Non-respiratory manifestations of COVID-19
When the reason for the encounter/admission is a non-respiratory
manifestation (e.g., viral enteritis) of COVID-19, assign code
U07.1, COVID-19, as the principal/first-listed diagnosis and
assign code(s) for the manifestation(s) as additional diagnoses.
(e) Exposure to COVID-19
For asymptomatic individuals with actual or suspected exposure
to COVID-19, assign code Z20.822, Contact with and
(suspected) exposure to COVID-19.
For symptomatic individuals with actual or suspected exposure
to COVID-19 and the infection has been ruled out, or test results
are inconclusive or unknown, assign code Z20.822, Contact with
and (suspected) exposure to COVID-19. See guideline
ICD-10-CM Official Guidelines for Coding andReporting
FY 2022
Page 29 of 115
I.C.21.c.1, Contact/Exposure, for additional guidance regarding
the use of category Z20 codes.
If COVID-19 is confirmed, see guideline I.C.1.g.1.a.
(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.
(g) Signs and symptoms without definitive diagnosis of COVID19
For patients presenting with any signs/symptoms associated with
COVID-19 (such as fever, etc.) but a definitive diagnosis has not
been established, assign the appropriate code(s) for each of the
presenting signs and symptoms such as:
• R05.1, Acute cough, or R05.9, Cough, unspecified
• R06.02 Shortness of breath
• R50.9 Fever, unspecified
If a patient with signs/symptoms associated with COVID-19
also has an actual or suspected contact with or exposure to
COVID-19, assign Z20.822, Contact with and (suspected)
exposure to COVID-19, as an additional code.
(h) Asymptomatic individuals who test positive for COVID-19
For asymptomatic individuals who test positive for COVID-19,
see guideline I.C.1.g.1.a. Although the individual is
asymptomatic, the individual has tested positive and is
considered to have the COVID-19 infection.
(i) Personal history of COVID-19
For patients with a history of COVID-19, assign code Z86.16,
Personal history of COVID-19.
(j) Follow-up visits after COVID-19 infection has resolved
For individuals who previously had COVID-19, without
residual symptom(s) or condition(s), and are being seen for
follow-up evaluation, and COVID-19 test results are negative,
assign codes Z09, Encounter for follow-up examination after
completed treatment for conditions other than malignant
neoplasm, and Z86.16, Personal history of COVID-19.
ICD-10-CM Official Guidelines for Coding andReporting
FY 2022
Page 30 of 115
For follow-up visits for individuals with symptom(s) or
condition(s) related to a previous COVID-19 infection, see
guideline I.C.1.g.1.m.
See Section I.C.21.c.8, Factors influencing health states and
contact with health services, Follow-up
(k) Encounter for antibody testing
For an encounter for antibody testing that is not being performed
to confirm a current COVID-19 infection, nor is a follow-up test
after resolution of COVID-19, assign Z01.84, Encounter for
antibody response examination.
Follow the applicable guidelines above if the individual is being
tested to confirm a current COVID-19 infection.
For follow-up testing after a COVID-19 infection, see guideline
I.C.1.g.1.j.
(l) Multisystem Inflammatory Syndrome
For individuals with multisystem inflammatory syndrome (MIS)
and COVID-19, assign code U07.1, COVID-19, as the
principal/first-listed diagnosis and assign code M35.81,
Multisystem inflammatory syndrome, as an additional diagnosis.
If an individual with a history of COVID-19 develops MIS,
assign codes M35.81, Multisystem inflammatory syndrome, and
U09.9, Post COVID-19 condition, unspecified.
If an individual with a known or suspected exposure to COVID19, and no current COVID-19 infection or history of COVID-19,
develops MIS, assign codes M35.81, Multisystem inflammatory
syndrome, and Z20.822, Contact with and (suspected) exposure
to COVID-19.
Additional codes should be assigned for any associated
complications of MIS.
(m)Post COVID-19 Condition
For sequela of COVID-19, or associated symptoms or
conditions that develop following a previous COVID-19
infection, assign a code(s) for the specific symptom(s) or
condition(s) related to the previous COVID-19 infection, if
known, and code U09.9, Post COVID-19 condition,
unspecified.
Code U09.9 should not be assigned for manifestations of an
active (current) COVID-19 infection.
ICD-10-CM Official Guidelines for Coding andReporting
FY 2022
Page 31 of 115
If a patient has a condition(s) associated with a previous
COVID-19 infection and develops a new active (current)
COVID-19 infection, code U09.9 may be assigned in
conjunction with code U07.1, COVID-19, to identify that the
patient also has a condition(s) associated with a previous
COVID-19 infection. Code(s) for the specific condition(s)
associated with the previous COVID-19 infection and code(s)
for manifestation(s) of the new active (current) COVID-19
infection should also be assigned.

AMA free tool:


COVID testing PDF


COVID scenarios:


CCO videos:













 
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