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Q&A: Coding Suspected COVID-19

Analysis  |  By Revenue Cycle Advisor  
   February 15, 2021

If a provider documents COVID-19 as "suspected," "possible," "probable," or "inconclusive," then U07.1 cannot be reported.

A version of this article was first published February 15, 2021, by HCPro's Revenue Cycle Advisor, a sibling publication to HealthLeaders.

Q: Can we use U07.1 (COVID-19 virus, identified) for suspected COVID-19 cases?

A: The ICD-10-CM guidelines now state you can only code confirmed cases of COVID-19, and only positive COVID-19 test results can be reported as well.

For a confirmed COVID-19 diagnosis, code U07.1 should be reported. This is an exception to inpatient coding guidelines, in which confirmation does not require documentation of a positive result, as the documentation by the provider is sufficient to report COVID-19.

If a provider documents COVID-19 as “suspected,” “possible,” “probable,” or “inconclusive,” then U07.1 cannot be reported.

As an alternative, you would code the signs and symptoms documented.

For more information, see "Review FY 2021 ICD-10-CM codes, guidelines for Chapter 1, COVID-19, and moreby Joe Rivet, Esq., CCS-P, CPC, CEMC, CHC, CCEP, CHRC, CHPC, CICA, CPMA, CAC, CACO, in the February issue of HIM Briefings.

Revenue Cycle Advisor combines all of HCPro's Medicare regulatory and reimbursement resources into one handy and easy-to-access portal. News is not just repeated from other sources. It is analyzed by our Medicare experts so professionals can comprehend any new rule and regulatory updates thoroughly. Learn more.

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