This information was updated March 16, 2020
The Centers For Disease Control and Prevention (CDC) has issued supplemental medical coding guidelines for encounters and telehealth screenings related to the COVID-19 Coronavirus. These codes are to be used in conjunction with the current ICD-10-CM classification and the ICD-10-CM Official Guidelines for Coding and Reporting.
The medical codes provided below are intended for use only in encounters related to COVID-19. For conditions unrelated to coronavirus, even if presenting simultaneously with COVID-19 symptoms, follow standard ICD-10-CM protocols. This coding guidance has been developed by the CDC and approved by the National Center for Health Statistics, the American Health Information Management Association, the American Hospital Association, and the Centers for Medicare & Medicaid Services.
Notes:
- If the COVID-19 encounter is documented as being associated with a respiratory infection, NOS, it would be appropriate to assign code J98.8.
- The diagnosis code B34.2 for Coronavirus infection, unspecified, is generally not appropriate for the COVID-19 virus, because the cases have universally been respiratory in nature, so the site would not be “unspecified.”
- If the encounter is documented as suspected, possible or probable COVID-19, do not assign code B97.29. Instead, assign a code(s) explaining the reason for the encounter (such as fever or Z20.828, confirmed case of exposure to Covid-19).
- For cases where there is a concern about possible exposure to COVID-19, but this is ruled out after evaluation, it would be appropriate to assign the code Z03.818, Encounter for observation for suspected exposure to other biological agents ruled out.
- For cases where there is actual exposure to someone who is confirmed to have COVID-19, it would be appropriate to assign the code Z20.828, Contact with and (suspected) exposure to other viral communicable diseases.
See the official document from the CDC here for more information.
Contact Advantum Health for more information on how to accurately code EHRs for COVID-19.
For cases confirmed as resulting from COVID-19 | |
| NOS=Not Otherwise Specified | |
| Diagnosis | ICD-10 Code for Covid-19 |
| Pneumonia | J12.89 |
| Acute Bronchitis | J20.8 |
| Bronchitis (NOS) due to Covid-19 | J40 |
| Lower respiratory infection (NOS) | J22 |
| Acute respiratory infection (NOS) | J22 |
| Acute Respiratory Distress Syndrome (ARDS) | J80 |
| Confirmed case of exposure to Covid-19 | Z20.828 |
Presenting symptoms without an established, definitive diagnosis | |
| Diagnosis | ICD-10 Code for Covid-19 |
| Cough | R05 |
| Shortness Of Breath | R06.02 |
| Fever, unspecified | R50.9 |
Telephone evaluation and management | |
| Codes for Physicians | ICD-10 Code for Covid-19 |
| 5-10 minute phone call with medical discussion | 99441 |
| 11-20 minute phone call with medical discussion | 99442 |
| 21-30 minute phone call with medical discussion | 99443 |
| Codes for Physician Extenders (Nurses, NPs, PAs) | |
| 5-10 minute phone call with medical discussion | 98966 |
| 11-20 minute phone call with medical discussion | 98967 |
| 21-30 minute phone call with medical discussion | 98968 |
Telehealth CodesOnline digital E&M service, for an established patient, for up to 7 days, cumulative time during the 7 days. | |
| Service | ICD-10 Code for Covid-19 |
| 5-10 minutes of medical discussion | 99421 |
| 11-20 minutes of medical discussion | 99422 |
| 21 or more minutes of medical discussion | 99423 |