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CDC Announces New ICD-10-CM Codes for COVID-19-related Conditions

Analysis  |  By Revenue Cycle Advisor  
   December 07, 2022

All six new codes were effective January 1, 2021.

A version of this article was first published December 7, 2020, by HCPro's Revenue Cycle Advisor, a sibling publication to HealthLeaders.

The Centers for Disease Control and Prevention (CDC) announced the implementation of six new ICD-10-CM codes to identify conditions related to novel coronavirus (COVID-19).

The new codes are:

  • J12.82, pneumonia due to COVID-19
    • Pneumonia due to SARS-CoV-2
  • M35.81, multisystem inflammatory syndrome
    • Multisystem inflammatory syndrome in children
    • Pediatric inflammatory multisystem syndrome
  • M35.89, other specified systemic involvement of connective tissue
  • Z11.52, encounter for screening for COVID-19
  • Z20.822, contact with and (suspected) exposure to COVID-19
    • Contact with and (suspected) exposure to SARS-CoV-2
  • Z86.16, personal history of COVID-19

Per the ICD-10-CM Tabular List of Diseases and Injuries, January 1 Tabular Addenda, when reporting code J12.82 or M35.81, coders must first report code U07.1 for COVID-19, if applicable.

A tabular note under code M35.81 instructs coders to use additional codes to report complications associated with multisystem inflammatory syndrome such as:

  • Acute hepatic failure (K72.0-)
  • Acute kidney failure (N17.-)
  • Acute myocarditis (I40.-)
  • Acute respiratory distress syndrome (J80)
  • Cardiac arrhythmia (I47-I49.-)
  • Pneumonia due to COVID-19 (J12.82)
  • Severe sepsis (R65.2-)
  • Viral cardiomyopathy (B33.24)
  • Viral pericarditis (B33.23)

Coders who report a diagnosis of multisystem inflammatory system using code M35.81 are also instructed to use additional codes, if applicable, to report:

  • Exposure to COVID-19 or SARS-CoV-2 infection (Z20.822)
  • Personal history of COVID-19 (Z86.16)
  • Sequelae of COVID-19 (B94.8)

All six new codes will be effective January 1. Full addenda information regarding the new codes is available here.

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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