COVID-19 Coding Guidelines

Effective: February 20, 2020 

As healthcare systems all over the country deal with the COVID-19 coronavirus outbreak, the Centers for Disease Control and Prevention (CDC) has provided an official diagnosis coding guidance for health care encounters and deaths related to COVID-19. This respiratory infection can cause a range of illness with little to no symptoms, to the affected falling severely ill, and in even worse cases resulting in death. 

ICD-10-CM codes provided in this blog from the CDC are meant to provide information on the coding of encounters related to COVID-19. Codes for conditions unrelated to COVID-19 may be required to fully code these scenarios in accordance with the ICD-10-CM Official Guidelines for Coding and Reporting. Our team at iSalus Healthcare has condensed this information for you below:

Pneumonia

A pneumonia case confirmed due to the 2019 novel coronavirus (COVID-19): J12.89

Acute Bronchitis 

A patient with acute bronchitis confirmed due to COVID-19: J20.8

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: J22

If the COVID-19 is documented as being associated with a respiratory infection, NOS: J98.8

ARDS

Acute Respiratory Distress Syndrome (ARDS) may develop with COVID-19, according to the Interim Clinical Guidance for Management of Patients with Confirmed 2019 Novel Coronavirus (COVID-19) Infection. 

Cases with ARDS due to COVID-19: J80

Exposure to COVID-19 

For cases where there is a concern about a possible exposure to COVID-19, but this is ruled out after evaluation, it would be appropriate to assign the code: Z03.818

For cases where there is actual exposure to someone who is confirmed to have COVID-19: Z20.828

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
• R06.02 Shortness of breath
• R50.9 Fever, unspecified 

Note: 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). 

For more detailed information regarding COVID-19 coding guidelines, please visit the CDC’s official document here.