Q&A: ICD-10-CM coding for COVID-19

Monday, March 30, 2020

Q:  Do you have any advice for accurate reporting of new ICD-10-CM code U07.1 (2019-nCoV acute respiratory disease)?

A: The Centers for Disease Control and Prevention (CDC) announced during its March ICD-10-CM Coordination and Maintenance Committee meeting that ICD-10-CM code U07.1 will be available for use starting April 1. The code will be housed in Chapter 22, Codes for Special Purposes (U00-U85).

This code is to be used for any illness caused by the novel coronavirus (COVID-19) that is confirmed by a positive test. Unfortunately, for some associated conditions, there is not a relevant ICD-10-CM code. For example, an ICD-10-CM code has not been created to identify the severe pneumonia caused by the COVID-19 virus that some patients are experiencing.

COVID-19 has a wide range of severities, and the accurate reporting of these severities and associated conditions will help healthcare providers and researchers better track, manage, and assess the COVID-19 outbreak. According to published guidance from the CDC National Center for Health Statistics, coders should report the new U07.1 code with additional ICD-10-CM codes to identify any manifestations of the virus, such as pneumonia, acute respiratory distress syndrome, or sepsis. For example, pneumonia confirmed as due to the COVID-19 requires code J12.89 (other viral pneumonia) in addition to U07.1. 

The new guidance include an Excludes1 note, instructing coders not to report the new code with ICD-10-CM code B34.2 (coronavirus infection, unspecified). COVID-19 cases have universally been respiratory in nature, so the site of the infection is not "unspecified." In addition, coders are instructed not to report code J12.81 (pneumonia due to SARS-associated coronavirus) with U07.1 since COVID-19 is a different phenotype of coronavirus than that associated with SARS.

Editor’s note: This question was answered by Jay Anders, MD, chief medical officer of Medicomp Systems, which provides point-of-care solutions to fix electronic health records.

This answer was provided based on limited information. Be sure to review all documentation specific to your own individual scenario before determining appropriate code assignment.