Q&A: Coding suspected COVID-19

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 more" by Joe Rivet, Esq., CCS-P, CPC, CEMC, CHC, CCEP, CHRC, CHPC, CICA, CPMA, CAC, CACO, in the February issue of HIM Briefings.