The Centers for Disease Control and Prevention (CDC) published the final guidelines for the new diagnosis code U07.1, COVID-19, effective April 1 to September 30, 2020. As a result, the Centers for Medicare & Medicaid Services (CMS) also updated the ICD-10-CM to Clinical Category Mapping for PDPM that takes effect April 1, 2020. The FY 2020 PDPM ICD-10 Mappings (ZIP) have been updated to reflect the new COVID-19 (U07.1 – 2019-nCoV acute respiratory disease) mapped to the Pulmonary category. CMS also issued a revision to the PDPM DLL Package (V1.0004 FINAL), which add support for the ICD-19-CM code for Coronavirus, U07.1. Providers should look for software updates from your vendor to account for this revision. Again, this code is only in effect for assessments with target date 04-01-2020 and later.  For additional information and FAQ from American Health Information Management Association (AHIMA) and American Hospital Association (AHA) on coding for COVID-19, click here.


CMS Webpage for ICD-10-CM to Clinical Category Mapping for PDPM

CMS Webpage for revision to the PDPM DLL Package (V1.0004 FINAL)


Blog by Stacy Baker, OTR/L, CHC, RAC-CT, Proactive Medical Review

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