The resurgence of COVID-19 cases necessitates a clear understanding of the correct diagnosis and procedure codes for healthcare providers. Accurate coding is crucial for proper documentation, billing, and public health tracking. This guide provides a concise overview of the essential Diagnosis Code Covid and testing codes you need to know.
ICD-10 Codes for COVID-19 Diagnosis
The International Classification of Diseases, 10th Revision (ICD-10) codes are used to classify and code diagnoses. When dealing with COVID-19, these are the primary ICD-10 codes to utilize:
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U07.1, COVID-19: This is the definitive diagnosis code for all confirmed COVID-19 cases. It should be used irrespective of the diagnosis method, whether based on laboratory testing, clinical symptoms, exposure history, or a combination of these factors. Essentially, if a patient is diagnosed with COVID-19, U07.1 is the appropriate diagnosis code.
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Z20.828, Contact with and (suspected) exposure to other viral communicable diseases: This code is applicable when there is suspicion of COVID-19 exposure, but a definitive diagnosis is pending. This situation often arises when a patient has had contact with a known case or presents with symptoms suggestive of COVID-19, but test results are not yet available. When using Z20.828, it’s important to also include codes for any symptoms the patient is exhibiting.
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B94.8, Sequelae of other specified infectious and parasitic diseases: This code addresses the long-term effects of COVID-19. It is used for patients experiencing ongoing health issues or complications that persist after the acute phase of the COVID-19 infection has resolved. B94.8 should always be used in conjunction with other diagnosis codes that specify the nature of the patient’s current symptoms or conditions resulting from the prior COVID-19 infection.
CPT Codes for COVID-19 Testing
Current Procedural Terminology (CPT) codes are used to report medical procedures and services, including COVID-19 testing. Here are the key CPT codes for different types of COVID-19 tests:
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87426, Infectious agent antigen detection by immunoassay technique…severe acute respiratory syndrome coronavirus (e.g., SARS-CoV, SARS-CoV-2): Code 87426 is used to report antigen tests for COVID-19. Antigen tests are known for their rapid turnaround time and ease of use, making them frequently employed in point-of-care settings. This code has been recently revised to specifically include SARS-CoV-2, the virus that causes COVID-19.
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86328, Immunoassay for infectious agent antibody(ies)…severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)…: This code is for reporting single-step antibody tests for COVID-19. Antibody tests identify the presence of antibodies developed in response to a previous or current SARS-CoV-2 infection. Code 86328 is specific to single-step antibody tests.
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87637, Infectious agent detection by nucleic acid (DNA or RNA)…severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)…, influenza virus types A and B, and respiratory syncytial virus, multiplex amplified probe technique: CPT code 87637 is a newer code designed for multiplex genetic tests that can simultaneously detect COVID-19, influenza A and B, and respiratory syncytial virus (RSV). For tests that only combine COVID-19 and influenza, report code 87636.
Understanding and correctly applying these diagnosis code covid and CPT codes is essential for accurate medical billing, data collection, and effective management of the ongoing COVID-19 situation. Staying updated on coding guidelines and revisions is crucial for all healthcare professionals involved in COVID-19 care.
