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Industry Insights

2021 Covid-19 coding update

The following Covid-19 coding changes are effective as of Jan. 1, 2021:

REMOVE:

  • Z20.828 should NO LONGER BE USED for possible or suspected exposure to Covid-19 for dates of service (DOS) on or after Jan. 1, 2021.
  • Z11.52 should NO LONGER BE USED for encounter screening.

NEW:

Pre-procedural testing:

  • Primary code: Z01.812 – Encounter for pre-procedural laboratory examination.
  • Secondary code: Z20.822 – Contact with and (suspected) exposure to other viral communicable diseases

Suspected or actual exposure to Covid-19 – Symptomatic/Asymptomatic:

  • Symptomatic Z20.822 – For symptomatic patients with actual exposure or suspected exposure to Covid-19 when the infection has been ruled out or test results are inconclusive or unknown.
    • Primary diagnosis should be Z20.822, while secondary codes should be signs and symptoms.
  • Asymptomatic Z20.822 – For asymptomatic patients with actual exposure or suspected exposure to Covid-19. No additional diagnoses code is needed.

Other new Covid codes:

  • J12.82 – Pneumonia due to Covid-19
  • M35.81 – Multisystem inflammatory syndrome
  • M35.89 – Other specified systemic involvement of connective tissue
  • Z86.16 – Personal history of Covid-19

Use of signs and symptoms:

For patients presenting with signs and symptoms, such as fever or cough, assign the appropriate code(s) for either confirmed exposure or suspected exposure use Z20.822 along with a diagnosis code for each of the signs and symptoms that present, such as:

  • R05 – Cough
  • R06.02 – Shortness of breath
  • R07.0 – Pain throat
  • R09.81 – Congestion
  • R43.9 – Loss of smell and taste
  • R50.9 – Fever
  • R68.83 – Chills without fever

CONTINUE:

  • U07.1 should continue to be used for confirmed cases of Covid-19 that will be reported to the CDC. This should only be used if Covid-19 has been confirmed!

RELATED: UHC Now Requiring G0416 for Prostate Biopsies

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