New COVID-19-related ICD-10-CM codes take effect

Editor’s note:For the latest news on COVID-19, visithttp://bit.ly/AAPNewsCOVID19.

International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) broke from the usual release schedule and implemented the following six new codes related to COVID-19 on Jan. 1 and issued accompanying guidelines.

Z20.822 Contact with and (suspected) exposure to COVID-19

• For asymptomatic individuals with actual or suspected exposure to COVID-19, assign code Z20.822. For symptomatic individuals with actual or suspected exposure to COVID-19 and the infection has been ruled out, or test results are inconclusive or unknown, assign code Z20.822.
• If a patient with signs/symptoms associated with COVID-19 also has an actual or suspected contact with or exposure to COVID-19, assign Z20.822 as an additional code.

Z11.52 Encounter for screening for COVID-19

During the COVID-19 pandemic, a screening code generally is not appropriate. Do not assign code Z11.52. For encounters for COVID-19 testing, including preoperative testing, code as exposure to COVID-19. Coding guidance will be updated as new information concerning changes in the pandemic status becomes available.

Z86.16 Personal history of COVID-19

For patients with a history of COVID-19, assign code Z86.16.

M35.81 Multisystem inflammatory syndrome (MIS)

• For individuals with MIS and COVID-19, assign code U07.1, COVID-19, as the principal/first-listed diagnosis and assign code M35.81 as an additional diagnosis.
• If MIS develops as a result of a previous COVID-19 infection, assign codes M35.81 and B94.8, Sequelae of other specified infectious and parasitic diseases.
• If an individual with a history of COVID-19 develops MIS and the provider does not indicate that MIS is due to the previous COVID-19 infection, assign codes M35.81 and Z86.16.
• If an individual with a known or suspected exposure to COVID-19 and no current COVID-19 infection or history of COVID-19 develops MIS, assign codes M35.81 and Z20.822.
• Assign additional codes for any associated complications of MIS.

M35.89 Other specified systemic involvement of connective tissue 

No guidance was created as this code had to be developed to stay within the coding conventions of an “other” code under M35.8-.

J12.82 Pneumonia due to coronavirus disease 2019 

For a patient with pneumonia confirmed as due to COVID-19, assign codes U07.1 and J12.82.

Be sure to update your ICD-10-CM codes and guidance for use of the new codes.