ICD-10 Code U07.1
COVID-19
What is the code U07.1?
The ICD-10-CM code U07.1 is designated for COVID-19, the disease caused by the novel coronavirus SARS-CoV-2. This code was introduced to facilitate the tracking and billing of COVID-19 cases in healthcare settings. It is specifically used to document confirmed cases of the coronavirus disease.
It is important to note that effective with the April 1, 2025 ICD-10-CM Official Coding Guidelines updates, a positive COVID-19 test result alone is not sufficient to assign code U07.1. The provider must clearly diagnose COVID-19 in their documentation, as a false positive laboratory test could be possible. It is the provider’s responsibility to confirm the diagnosis and document accordingly.
Detailed description of U07.1
U07.1 is used to identify and record cases of COVID-19. This code is applicable when a provider documents in the assessment portion of the note that a patient is diagnosed with COVID-19. The code helps in the systematic collection of data on the incidence and prevalence of the disease, which is crucial for public health management and epidemiological studies.
Symptoms commonly associated with U07.1
Patients diagnosed with COVID-19 under the U07.1 code may exhibit a variety of symptoms, including but not limited to:
- Fever
- Cough
- Shortness of breath
- Fatigue
- Muscle or body aches
- Loss of taste or smell
- Sore throat
- Congestion or runny nose
- Nausea or vomiting
- Diarrhea
Related and similar ICD-10 codes
Several other ICD-10 codes may be related to or used in conjunction with U07.1, including:
- J12.82: Pneumonia due to COVID-19
- J12.81: Pneumonia due to SARS-associated coronavirus
- B97.29: Other coronavirus as the cause of diseases classified elsewhere
- Z20.828: Contact with and (suspected) exposure to other viral communicable diseases
- Z86.16: Personal history of COVID-19
Appropriate usage of U07.1 for billing
Use U07.1 for billing when a provider documents in the assessment portion of the note that a patient has been confirmed to have COVID-19. This code ensures that the healthcare provider is reimbursed for the care provided to the patient and that the case is accurately recorded in health records for future reference and public health reporting.
Instructional guidelines for coding U07.1
When the reason for the encounter is a respiratory or non-respiratory manifestation of COVID-19, assign code U07.1, COVID-19, as the first-listed diagnosis. Additional codes should be assigned for any specific manifestations or associated conditions, unless other guidelines dictate a different sequencing of codes (such as in obstetrics, sepsis, or transplant complications).
Common respiratory manifestations of COVID-19 include pneumonia, acute bronchitis, lower respiratory infection, acute respiratory distress syndrome, and acute respiratory failure. Non-respiratory manifestations may include viral enteritis, coagulopathy, and hypercoagulable states.
Common pitfalls in coding with U07.1
Some common pitfalls to avoid when coding with U07.1 include:
- Using the code for suspected or probable COVID-19 cases without confirmation.
- Failing to include additional codes for related conditions or complications.
- Incorrectly coding for COVID-19 in the absence of a confirmed diagnosis.
- Not updating patient records to reflect the most current diagnosis and treatment information.
Key resources for U07.1 coding
- ICD-10-CM Official Guidelines for Coding and Reporting
- Centers for Disease Control and Prevention (CDC) COVID-19 coding resources
- American Health Information Management Association (AHIMA) COVID-19 coding guidelines
- World Health Organization (WHO) ICD-10 updates and resources
Conclusion
Adherence to coding guidelines and best practices for ICD-10-CM code U07.1 helps ensure proper reimbursement and contributes to the effective management of COVID-19. Healthcare providers should stay informed of any updates or changes to coding practices related to COVID-19 to maintain compliance and accuracy in their records.
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