COVID-10 HCPCs, CPT and ICD-10 Coding Guidance

As we continue to work through the COVID-19 pandemic, the RevCycle+ Education Team has created all-inclusive guidelines to assist in coding services related to COVID-19. These are intended to serve as a guide only. Charge assignment will vary from scenario to scenario. Please use discretion when assigning codes.

 

CPT/HCPCS codes for COVID-19 Testing

 

Medicare and Medicaid may set up their own more specific codes sets in HCPCS, while all other carriers will use CPT.

 

HCPCS U0001 CDC 2019 Novel Coronavirus Real Time RT-PCR Diagnosis

  • Test Panel

 

HCPCS U0002 2019-nCoV Coronavirus, SARS-CoV-2/2019-nCoV (COVID-19) using any technique, multiple types or subtypes (includes all targets

 

CPT 87635 SARS-COV-2 COVID-19 AMP PRB (short description)

  • 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 (Long description)

 

 

Diagnosis Code Guidance for COVID-19

 

Pneumonia

Pneumonia case confirmed as due to the 2019 novel coronavirus (COVID-19)

Assign codes:

  • J12.89, Other viral pneumonia
  • B97.29, Other coronavirus as the cause of diseases classified elsewhere

 

 

Acute Bronchitis

Acute bronchitis confirmed as due to COVID-19

Assign codes:

  • J20.8, Acute bronchitis due to other specified organisms
  • B97.29, Other coronavirus as the cause of diseases classified elsewhere

 

 

Bronchitis

Bronchitis not otherwise specified (NOS) due to the COVID-19

Assign codes:

  • J40, Bronchitis, not specified as acute or chronic
  • B97.29, Other coronavirus as the cause of diseases classified elsewhere

 

 

Lower Respiratory Infection

Lower respiratory infection, not otherwise specified (NOS), or an acute respiratory

infection, NOS, due to COVID-19

Assign codes: 

  • J22, Unspecified acute lower respiratory infection
  • B97.29, Other coronavirus as the cause of diseases classified elsewhere

 

 

Respiratory Infection

Respiratory infection due to COVID-19

Assign codes:

  • J98.8, Other specified respiratory disorders
  • B97.29, Other coronavirus as the cause of diseases classified elsewhere

 

 

Acute respiratory distress syndrome (ARDS)

ARDS due to COVID-19

Assign codes:

  • J80, Acute respiratory distress syndrome
  • B97.29, Other coronavirus as the cause of diseases classified elsewhere

 

 

Concern for Exposure to COVID-19

Concern regarding a possible exposure to COVID-19, but this is ruled out after

evaluation

Assign code:

  • Z03.818, Encounter for observation for suspected exposure to other biological agents ruled out

 

 

Exposure to COVID-19

Actual exposure to someone who is confirmed to have COVID-19

Assign code:

  • Z20.828, Contact with and (suspected) exposure to other viral communicable diseases

 

 

Signs and Symptoms

Patients presenting with any signs/symptoms (such as fever, etc.) and where a

definitive diagnosis has not been established.

Assign appropriate code(s) for each of the presenting signs/symptoms such as:

  • R05 Cough
  • R06.02 Shortness of breath
  • R50.9 Fever, unspecified

Documentation states "suspected", "possible" or "probable" COVID-19

  • DO NOT assign code B97.29
  • Assign a code(s) explaining the reason for encounter (such as fever, or Z20.828)

 

 

If you have any questions for our coding experts, feel free to email information@revcplus.com and a team member will respond to you promptly.