COVID-19 ICD-10-CM Effective April 1
On 3/18/20, the Centers for Disease Control and Prevention (CDC) announced that the effective date of a new diagnosis code U07.1, COVID-19, from October 1, 2020 to April 1, 2020. According to the CDC, “this off-cycle update is unprecedented and is an exception to the code set updating process established under HIPAA,” citing sections 201 and 301 of the National Emergencies Act.
Below is a table of the ICD-10-CM interim coding guidance. This guidance can be found here.
2019 Novel Coronavirus (COVID-19) Interim Coding Advice
| Disease/Condition due to COVID-19 | ICD-10 Code | Description |
| COVID-19 | U07.1 | COVID-19 Emergency ICD-10 code |
| Pneumonia | J12.89 with | Other viral pneumonia |
| B97.29 | *Other coronavirus as the cause of diseases classified elsewhere | |
| Acute Bronchitis | J20.8 with B97.29* | Acute bronchitis due to other specified organisms |
| Bronchitis not otherwise specified (NOS) | J40 with B97.29* | Bronchitis, not specified as acute or chronic |
| Lower Respiratory Infection | J22 with B97.29* | Unspecified acute lower respiratory infection |
| Respiratory Infection NOS | J98.8 with B97.29* | Respiratory infection, NOS |
| Adult Respiratory Distress Syndrome (ARDS) | J80 with B97.29* | Acute respiratory distress syndrome |
| Possible Exposure but ruled out | Z03.818 | Encounter for observation for suspected exposure to other biological agents ruled out |
| Actual exposure | Z20.828 | Contact with and (suspected) exposure to other viral communicable diseases |
Additional COVID-19 Coding Notes
- 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.”
- 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).
- Section I coding requirements must still be met:
- Active Diagnoses – Physician-documented diagnoses in the last 60 days that have a direct relationship to the resident’s current functional status, cognitive status, mood or behavior, medical treatments, nursing monitoring, or risk of death during the 7-day look-back period.
- ICD-10 Codes for Signs and symptoms – For patients presenting with any signs/symptoms (such as fever, etc.) and where a definitive diagnosis has not been established, assign the appropriate code(s) for each of the presenting signs and symptoms such as:
- R05 Cough
- 02 Shortness of breath
- 9 Fever, unspecified
Blog by Kristen Walden, MSN, RN RAC-CT, Clinical Consultant, Proactive Medical Review
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