2021 E/M Coding Changes – iSalus Healthcare’s Plan
On January 1st, 2021, the new rules related to billing for Office Visits, set forth by ...
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:
A pneumonia case confirmed due to the 2019 novel coronavirus (COVID-19): J12.89
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
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:
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.