COVID-19’s Effect on Medical Coding
The COVID-19 pandemic has left its mark on every facet of healthcare, including medical coding. These changes span the creation of unique ICD-10 codes, and the importance of remote coders as a workforce.
Because we have teams of coding experts providing full-service solutions for complex outpatient and inpatient coding, we have monitored this situation carefully. As of April 2020, here are the latest developments.
The WHO has created a unique ICD-10 code set for COVID-19
Coding workflows and how to review charts haven’t changed, but like any new disease or procedure that has manifested or been created, a new code set and educational material has been issued to properly identify this new disease. The material provided shares the proper way of how and when to assign the code. This has taken effect as of April 1 – September 30 with more expected changes as this viral disease progresses.
The unique ICD-10 code set given to COVID-19 is:
U07.1- COVID-19 – assign this code for confirmed cases of COVID-19
B34.2- Coronavirus infection unspecified– typically would not be assigned for a COVID-19 patient/case as the virus would not be identified as “unspecified” since it is been universally known as a respiratory infection
B97.29- other coronavirus as the cause of diseases classified elsewhere– assign this code as an additional diagnosis code when you have a separate respiratory illness such as Pneumonia, Bronchitis, etc. that is due to COVID-19
Z20.828- Contact with and (suspected) exposure to other viral communicable disease- assign this code if the patient is suspected to have been in contact or exposed to an individual that has tested positive for the COVID-19 virus
Z03.818- Encounter for observation for suspected exposure to other biological agents ruled out– assign this code when there is a concern that the patient has experienced a possible exposure, but the case has been ruled out after evaluation
Z11.59- Encounter for screening for other viral diseases– assign this code if the patient is being screened for COVID-19 due to a “possible” or actual exposure to the viral disease and the test results are either unknown or negative
Make sure you always follow proper coding guidelines when assigning these codes as published by the WHO Family of International Classification (WHOFIC).
AMA published new CPT codes related to COVID-19 Testing
Prior to this pandemic, COVID-19 testing did not exist. As with any test a CPT code needs to be assigned for tracking and reimbursement purposes. The AMA has published guidance to use CPT code 87635 for COVID-19 testing. Since this is new, it is likely that healthcare entities must manually load it into their EHRs.
Since the CPT 2020 publication has already been released, the 87635 code will not be found; however, it will be included in the CPT 2021 code set in the Microbiology subsection of the Pathology and Laboratory section.
CPT codes to note related to COVID-19 testing:
87635 – Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]), amplified probe technique.
99000 – Handling and/or conveyance of specimen for transfer from the physician’s office to a laboratory. (Use this code if the specimen is prepared by your office and sent to an outside lab, report the specimen collection code.)
99001 – Handling and/or conveyance of specimen for transfer from the patient in other than an office to a laboratory (distance may be indicated) (Use when directing patient to a testing site.)
The Centers for Medicare & Medicaid Services (CMS) developed two new lab testing codes:
U0001 – Use to report coronavirus testing using the CD) 2019 Novel Coronavirus Real Time RT-PCR Diagnostic Test Panel.
U0002 – Use to report validated non-CDC laboratory tests for SARS-CoV-2/2019-nCoV (COVID-19).
If your office is not running the test for COVID-19 or incurring the cost, you will not report these codes.
Make sure to stay informed as new updates emerge from WHO and the CDC. Coding updates and guidance are typically released in the 4th quarter of each year, often October 1.
Work from Home is essential to coding delivery, and disruptive to some organizations
While remote coding is a widely accepted practice, there are still plenty of companies without a work from home (WFH) model where coders still report to the office daily. The pandemic has created disruption for these companies as they seek to transition their workforce to WFH.
Companies with outsourced coding vendors may feel the impact on their remote teams that could lead to a temporary backlog if those vendors have closed their facilities while other vendors have mobilized WFH measures. As with any adjustment, companies are learning to setup new processes and procedures to keep coders operational and engaged.