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Coding Tip: Update – Coding COVID-19 When the Test is Negative

by Aug 6, 2020Coding Tips, Coronavirus, COVID-19, Education, ICD-10, Patricia Maccariella-Hafey0 comments

Patricia Maccariella-Hafey, RHIA, CDIP, CCS, CCS-P, CIRCC has over 35 years expertise in the areas of ICD-9-CM, CPT, DRG/APC validation Professional Fee E&M coding, Interventional Radiology, and Facility E&M coding. Patricia is currently Director of Education a healthcare consulting firm specializing in coding compliance review, education and contract coding services.

Pat Maccariella‑Hafey
RHIA, CDIP, CCS, CCS‑P, CIRCC

Executive Director Of Education
AHIMA‑Approved ICD‑10‑CM/PCS Trainer and Ambassador

As you may know, assigning the appropriate Z code for patients who present for COVID-19 testing where the test result is negative has been a confusing area.  Early on 4/16/20 in AHA’s FAQ  of it was recommended to code Z20.828, “Contact with and (suspected) exposure to other viral communicable diseases” when the patient had symptoms and exposure to COVID-19 and tested negative, to assign Z03.818, “Encounter for observation for suspected exposure to other biological agents ruled out” when the test was negative, and Z11.59, Encounter for screening for other viral diseases” when there were no symptoms and no exposure and the patient was just being tested to see if they had COVID-19 and the results were negative.

As of August 5, 2020, AHA has deleted the above advice and FAQ and added two new FAQ’s, 38 and 39 that state to assign code Z20.828, “Contact with and (suspected) exposure to other viral communicable diseases” for all patients who are tested for COVID-19 and the results are negative, regardless of symptoms, no symptoms, exposure or not as we are in a pandemic.

In FAQ #38 it was asked what code should be assigned for an encounter for COVID-19 screening such as part of preoperative testing when the COVID-19 test is negative. The answer is to assign Z01.812, “Encounter for preprocedural laboratory examination” as the first diagnosis and code Z20.828, “Contact with and (suspected) exposure to other viral communicable diseases” as a secondary diagnosis if the COVDI-19 testing is being performed as part of a preoperative testing visit.

If not preoperative, and screening is done, assign code Z20.828 only.  This is because we are in a COVID-19 pandemic and the screening code would not be appropriate.

FAQ#39 reiterated that Z20.828 should be used for all COVID-19 testing that the result is negative. If the result is positive, then assign U07.1, “Covid-19.”

So it appears that now the AHA FAQ and the Official Guidelines for Coding and Reporting for FY2021 are in sync regarding negative test results for COVID-19 testing.

Also in the link below which contains the updated FAQ for August 5, 2020, there is a new section that addresses FAQ for COVID-19 procedure questions.    There are three additional FAQs added for 8/5/2020 and advise that the new technology codes for the specific drugs listed, and for introduction of “Other new technology therapeutic substance are ONLY assigned  when the drugs are used to treat COVID-19 patients, not when the drugs are used to treat other conditions in patients.

I highly recommend that coders review these new additions immediately at the link below.

References
https://www.codingclinicadvisor.com/sites/default/files/Frequently%20Asked%20Questions%20Regarding%20COVID-19_v12_0.pdf

The information contained in this post is valid at the time of posting. Viewers are encouraged to research subsequent official guidance in the areas associated with the topic as they can change rapidly.

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