Tuesday, August 4, 2020

Breaking Coding News: New COVID-19 Codes!


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:

New Technology

     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 

Dianna Foley, RHIA, CHPS, CCS  is OHIMA's Coding Education Coordinator. Dianna has been an HIM professional for 20 years. She progressed through the ranks of coder, department supervisor, and department director, to her current role as a coding consultant. 

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.

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