In our ever changing COVID-19 world, another unprecedented coding change is taking place effective August 1, 2020. The Centers for Medicare and Medicaid Services (CMS) has updated the ICD-10-PCS classification to include twelve (12) New Technology codes designed to capture treatment of patients with COVID-19. Codes have been created for Introduction of substances like Remdesivir which will be found in the XW0 table, as well as Infusion of convalescent plasma located in the XW1 table.Here are the new treatments that are being added:
Add Plasma, Convalescent (Nonautologous) XW1
Add Remdesivir Anti-infective XW0
Add Sarilumab XW0
Add Tocilizumab XW0
Add Other New Technology Therapeutic Substance XW0
This is a list of trade names or other identifiers of these medications and their New Technology equivalent:
GS-5734 use Remdesivir Anti-infective
Veklury use Remdesivir Anti-infective
KEVZARA(R) use Sarilumab
ACTEMRA(R) use Tocilizumab
Remember, these codes are to be used for coding of
discharges on or after August 1, 2020.
Also, note that none of these ICD-10-PCS codes will impact DRG
assignment. However, it is encouraged
that these codes be assigned as applicable as they can assist in evaluating
treatment and monitoring outcomes for patients.
Additional information regarding these updates can be found on the CMS website at: https://www.cms.gov/Medicare/Coding/ICD10/2020-ICD-10-PCS?mkt_tok=eyJpIjoiT1dJMFlqTmlNVGd4WVRabSIsInQiOiJjZHRjXC9sa0h1S1NRVjAyR0N3MHpHNkJXczU5TEJJK2pJeEE0a1BLcUVOZ1ZNb2c0XC9ieE1nMkJyaDdZSkxUcGQ0bDVpVE9MZzd5amxHS1FKNVAwRURTUXJOQW1OUFc5V1duNlYzU0lhZlFhR240VXNjbGNuUEh3Y3ZDMHZ4OWFBIn0%3D
The American Hospital Association (AHA) along with the
American Health Information Management Association (AHIMA) again updated the
frequently asked questions (FAQs) regarding ICD-10-CM coding related to
COVID-19. The updated questions address
coding for multi-system inflammatory syndrome in children by using ICD-10-CM
code M35.8 for Other specified systemic involvement of connective tissue. Further clarification is provided for
sequencing based on whether the child currently has COVID-19 or if the
condition has developed after the COVID infection has resolved.
Other topics covered in the updated FAQs include the creation of the new ICD-10-PCS codes for COVID-19 treatment outlined above, along with coding for post-acute care encounters, and appropriate codes to be assigned for any manifestations that arise after a COVID-19 infection is resolved.
The updated FAQs can be found here:
More than ever, it is vital that coding professionals stay up-to-date on the most current coding information. We have already seen unparalleled steps taken this year by the co-operating parties to ensure that coding of COVID-19 could be captured specifically with the designation of U07.1. Official guidance has been provided as more information regarding the disease has become evident. This continues to be a fluid situation and there may be more changes to come. OHIMA will continue to ensure that coding professionals are aware of these changes.
About the Author
She recently served as the program director for Medical Coding and HIT at Eastern Gateway Community College. Dianna earned her bachelor's degree from the University of Cincinnati subsequently achieving her RHIA, CHPS, and CCS certifications. She is an AHIMA Approved ICD-10-CM/PCS Trainer and a a presenter at regional HIM meetings and the OHIMA Annual Meeting.