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

Click here to learn more about Kristen and the rest of the Proactive team.