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Alert: New COVID-19 ICD-10-CM Diagnosis Code, CPT® and HCPCS Codes

  • by Steve Nesnidal, MD, CPC, AHFI
  • Jun 2, 2020, 09:33 AM

In response to the Novel Coronavirus pandemic, a new ICD-10-CM code was moved up from previous posted effective date of October 1, 2020 to April 1, 2020.  The American Medical Association (AMA) has also added three new CPT® codes and updated an existing CPT code description. Proper and timely use of these new codes is necessary for payers to properly identify and process COVID-19 related claims.  This also provides researchers with important detail that will facilitate effective monitoring of pandemic related data trends.

The new ICD-10-CM diagnosis code, U07.1, is effective 4/1/2020.  The Centers for Disease Control (CDC) guidelines on how this code should be applied can be found at https://www.cdc.gov/nchs/data/icd/COVID-19-guidelines-final.pdf

The new CPT® codes released by the AMA – 87635, effective 3/13/2020 and codes 86328 and 86769, both effective 4/10/2020.  Existing CPT® code 86318 code description has been updated, and this is also effective 4/10/2020.  

Additional coding guideline information can be found on the AMA’s website at https://www.ama-assn.org/practice-management/cpt/covid-19-coding-and-guidance

A series of COVID-19 related HCPCS codes have also been released by CMS:

G2025 effective 1/27/2020

U0001 and U0002  effective 02/04/2020

C9803 effective 03/01/2020

U0003  and U0004 effective 04/14/2020

Additional information can be sourced from CMS HCPCS webpage at https://www.cms.gov/index.php/Medicare/Coding/MedHCPCSGenInfo/HCPCS_Coding_Questions

Context 4 Healthcare has included all coding updates and modifications in all of our CPT®, HCPCS, and ICD products.

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