Q&A: Reporting COVID-19 without respiratory manifestations in ICD-10-CM

Q: How should we report positive COVID-19 cases in ICD-10-CM without respiratory manifestations or any signs or symptoms and no prior suspected exposure?

A: Patients who are considered asymptomatic without known exposure should be reported with first-listed ICD-10-CM code Z11.59 (screening for other viral diseases) with an additional code B97.29 (other coronavirus as the cause of diseases classified elsewhere). In the February 20 interim coding guidance from the Centers for Disease Control and Prevention, ICD-10-CM code B97.29 was identified as the temporary code to identify COVID-19 cases.   

B97.29 cannot be reported as a standalone diagnosis code, per the ICD-10-CM manual instructional notes for categories (B95-B97). However, as per the ICD-10-CM Official Guidelines for Coding and Reporting, a screening code may be used as a first-listed code if it is the reason for the visit, or it can be used as an additional code if done during an office visit for other health problems. An additional code should be assigned for any conditions discovered during the screening. 

As of April 1, ICD-10-CM code U07.1 would be assigned for any positive COVID-19 patient with or without symptoms.

Some concessions have been made about sequencing for the B97.29 code in the unprecedented time of the pandemic. However, it is important to identify all positive COVID-19 cases using either B97.29 or U07.1 for accurate case capture.

Editor’s note: This question was answered by Shannon McCall, RHIA, CCS, CCS-P, CPC, CEMC, CRC, CCDS, CCDS-O, director of HIM and coding for HCPro in Middleton, Massachusetts.

This answer was provided based on limited information. Be sure to review all documentation specific to your own individual scenario before determining appropriate code assignment.