ICD-10 FAQ

General Guidance for coding COVID-19 (effective January 1, 2021):

When the COVID-19 virus is confirmed, code first ICD-10-CM U07.1 COVID-19, followed by the disease, condition or manifestation associated with the COVID-19 virus. “Confirmation” does not require a positive test but may be physician documentation confirming the patient has COVID-19.This includes asymptomatic patients as well. When COVID-19 is the reason for care in a pregnant patient, the pregnancy code O98.5- (Other viral diseases complicating pregnancy, and childbirth), should be sequenced first with confirmed COVID-19 (U07.1) and any manifestation listed as additional diagnoses. For patients with suspected COVID-19 assign codes for the presenting signs and symptoms along with Z20.822 (Contact with and (suspected) exposure to COVID-19).

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While there is a code Z11.52, Encounter for screening for COVID-19, it is not to be used during the current PHE. Effective January 1, 2021,the ICD-10-CM Official Guidelines for Coding and Reporting states that code Z20.822 should be used for screening for asymptomatic patients who are suspected to have been exposed to a disease by close personal contact with an infected individual or are in an area where a disease is epidemic, symptomatic patients with a negative test (and not otherwise confirmed by documentation), and pre-operative testing.

Code M35.81 is used for Multisystem Inflammatory Syndrome (MIS). List U07.1 if the patient has confirmed COVID-19 at the time of the encounter. In patients where a previous COVID-19 infection is documented as the cause of the MIS, then list MIS as the first diagnosis and B94.8 (Sequelae of other specified infectious) in addition. If the patient has a known or suspect contact with COVID-19 but no current or previous COVID-19 infection list MIS first and Z20.822 in addition. Be sure to list any manifestations associated with the MIS.

At this writing, there are no specific codes to identify adverse effects, allergic reactions or anaphylaxis specifically for COVID-19 vaccines. For adverse effect(s) of COVID-19 vaccine, code first the manifestation(s) (e.g. fatigue R53.83), and T50.B95A (Adverse effect of other viral vaccines, initial encounter) as additional diagnosis. For anaphylaxis resulting from COVID-19 vaccine, code T80.52XA, followed by other conditions as appropriate. For allergic reaction to COVID-19 vaccine, code first T78.49XA, other allergy, followed by manifestation(s).

Clinical Impression

Code First

Also Code

Confirmed COVID-19 pneumonia

U07.1

J12.82

Acute bronchitis due to other specified organisms

U07.1

J20.8

Bronchitis , not specified as acute or chronic

U07.1

J40

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Unspecified acute lower respiratory infection

U07.1

J22

Respiratory Infection NOS, Other specified resp. disorders

U07.1

J98.8

Acute Respiratory Distress Syndrome (ARDS)

U07.1

J80

Multisystem Inflammatory Syndrome

See above

Manifestations

Pregnancy with confirmed COVID-19

O95.5-

U07.1

Suspected possible COVID-19 exposure ruled out

Z20.822

Other Conditions

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Exposure to someone confirmed to have COVID-19

Z20.828

Other Conditions

Personal History of COVID-19

Other Conditions

Z86.16

Anaphylaxis due to COVID-19 vaccine

T80.52XA

Other Conditions

Allergic Reaction to COVID-19 vaccine

T78.49XA

Manifestation

Adverse effect COVID-19 vaccine

Manifestation

T50.B95A

ICD-10-CM Official Guidelines for Coding and Reporting FY 2022

ICD-10-CM Codes for COVID-19, Dec. 3, 2020, Effective Jan. 1, 2021

AHIMA and AHA FAQ: ICD-10-CM/PCS Coding for COVID-19 [Updated 8-27-2021]

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