As the COVID-19 pandemic continues to impact our healthcare system, relevant coding and billing guidelines are being updated. This information is essential to maintaining the timeliness and accuracy of healthcare administration. However, it can be difficult to locate and keep track of COVID-19 related changes. Medliminal wants to continue to be a resource to our partners, supporters, and colleagues during this time by reporting the most accurate and up-to-date information regarding coding and billing guideline updates.
Medliminal’s claim analysts have identified the following COVID-19 related updates to coding and billing guidelines.
On April 1, 2020 and after for a confirmed COVID-19 diagnosis, use the code: U07.1, COVID-19
This code should be sequenced first, followed by codes for associated manifestations, except in the case of obstetrics patients.
During pregnancy, childbirth or the puerperium, a patient admitted (or presenting for a health care encounter) because of COVID-19 should receive a principal diagnosis code of O98.5-, Other viral diseases complicating pregnancy, childbirth and the puerperium, followed by code U07.1, COVID-19, and the appropriate codes for associated manifestation(s).
The ICD-10 MS-DRG Grouper assigns each case into an MS-DRG based on the reported diagnosis and procedure codes and demographic information (age, sex and discharge status). The ICD-10 MS-DRG Grouper software package to accommodate the new U07.1, COVID-29 diagnosis code, Version 37.1 R1, is effective for discharges on or after April 1, 2020.
National Uniform Billing Committee (NUBC) Guidance: Claims for COVID 19 Treatment
Usage of the “DR” condition code:
Without codes to specifically indicate COVID-19 (including those cases for which services were provided but the patient ultimately tested negative), the ability of payers to trigger special handling of institutional claims for COVID-19 related services has been significantly limited.
NUBC Recommendation: In order to ensure appropriate flagging of COVID-19 related care, institutional claims for COVID-19 diagnosis or treatment should include:
- The “DR” condition code, which is used to identify claims that are or may be impacted by specific policies related to a national or regional disaster/emergency.
- An appropriate service date. The “DR” condition code should be utilized for COVID-19 related care occurring since January 27th, the date that the Department of Health and Human Services declared the COVID- 19 crisis as a federal public health emergency (January 27th, 2020)
Utilization of Hospital Outpatient Bill Type for COVID Testing Locations:
In order to meet patient needs, many hospitals and health systems have moved testing locations from hospitals to off-campus facilities (e.g. parking lots, parks, football stadiums). In such cases, the NUBC recommends usage of the Hospital Outpatient Type of Bill (013x), the main hospital address and National Provider Identifier (NPI). When paired with the DR condition code (as directed above), the claim will help payers correctly apply site of service restrictions/edits.
New HCPCS and CPT COVID- 19 codes:
- U0001 - CDC 2019-nCoV Real-Time RT-PCR Diagnostic Panel CDC testing laboratories
- U0002 - non-CDC 2019-nCoV Coronavirus, SARS-CoV-2/2019-nCoV (COVID-19), any technique, multiple types or subtypes (includes all targets) non-CDC testing laboratories
- 87635 - Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]), amplified probe technique
New COVID-19 Specimen collection fee HCPCS codes:
- G2023 - Specimen collection for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]), any specimen source
- G2024 - Specimen collection for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]), from an individual in a skilled nursing facility or by a laboratory on behalf of a home health agency, any specimen source
In addition to taking the proper handwashing and social distancing precautions, it’s important to stay updated and educated on the most recent COVID-19 news. Medliminal recommends taking care to ensure the source and accuracy of any information regarding the pandemic. Below are some of the most recent COVID-19 updates and links to reliable resources.
Telehealth has become a critical tool in the fight to slow the spread of COVID-19. Utilizing telehealth prevents patients from having to travel to their provider’s physical location, inhibiting those who might carry the virus from spreading it to others. This solution can also help moderate the flow of patients into hospitals at a time when facilities are already being overwhelmed. It’s important to note that CMS has expanded reimbursements for telehealth services to Medicare beneficiaries. Review the Health & HumanServices Telehealth FAQ and HIPPA Sheet for more information.
Being aware of and maintaining our mental health is just has important as safeguarding our physical health during this pandemic. These sudden and unexpected changes to daily life can be stressful and mentally taxing, however, they don't need to be confronted alone. The CDC has made recommendations for coping with any new-found stress or anxiety and supporting those around us who might be struggling. Furthermore, there are resources available 24/7 that are dedicated to giving crisis-related counseling and support. If you or a loved one are struggling, please seek any help you might need and contact a mental health professional.
Many American workers are required to work remotely, which poses unique challenges. The transition from working in the office to working from home is difficult enough as it is, but those who have a spouse, animals, roommates, or children, may be facing more distractions and hurdles to completing their work. Medliminal recently released our tips on working from home, but if you or your company are still considering remote work, the CDC has released recommendations and guidelines.
How is Medliminal responding to Coronavirus?
Medliminal has set forth a plan that allows our employees to work from home, as their health and safety is our main priority. Our team is closely monitoring the situation as it develops and will make adjustments as necessary. Our clinical nurses and coding professionals have been extremely vigilant about the ever evolving COVID-19 medical billing updates and will continue to update our process as required.
We have spoken out on the issue and would like to assure our clients that there will be no lapse in service. Our team will continue to provide expert-level quality work and support during this time and will include our clients in any pertinent updates.
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Information for providers, institutional physicians, and industry professionals:
General facts and advice: