Since the COVID-19 public health emergency was declared, diagnosis codes for reporting actual or suspected exposure to COVID-19 have been updated. This article provides coding tips, based on the current official 2021 ICD-10 guidelines, for using the new ICD-10 diagnosis code Z20.822. This diagnosis code can be reported for dates of service on or after January 1, 2021.
|Patient has no signs/symptoms and has actual or suspected exposure to COVID-19.||Report Z20.822.|
|Patient is symptomatic and has actual or suspected exposure to COVID-19. COVID-19 is ruled out, or tests results are inconclusive or unknown.||Report signs/symptoms diagnosis code(s) and Z20.822.|
|Patient has signs/symptoms normally associated with COVID-19 and has actual or suspected contact with, or exposure to, COVID-19.||Report signs/symptoms diagnosis code(s) and Z20.822. Report U07.1 only for confirmed cases, as documented by the provider or when there is documentation of a positive COVID-19 test.|
|Patient presents with known or suspected exposure to COVID-19, has no current COVID-19 infection or history of having COVID-19, and is diagnosed with multisystem inflammatory syndrome.||Report diagnosis code for multisystem inflammatory diagnosis and Z20.822.|
|Patient presents for COVID-19 testing.||Report Z20.822.|
|Patient presents for COVID-19 testing prior to surgery (preoperative testing).||Report the reason for surgery as the primary diagnosis code and Z20.822 as an additional diagnosis code.|
Members are still responsible for their cost share if they received services unrelated to COVID-19, even if a COVID-19 diagnosis was present on the claim.
For a complete summary of COVID-19 diagnosis coding guidelines in place as of January 1, 2021, please refer to the links provided below:
For additional information on CDPHP’s COVID-19 testing policy, please refer to COVID-19 Testing, 1550/20.000219, on the CDPHP Secure Provider Portal.