ICD-10 Coding for COVID-19 Positive(U07.1, Z20.828, Z86.19)
Complete ICD-10-CM coding and documentation guide for COVID-19 Positive. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to COVID-19 Positive
U07.1Primary Range
COVID-19, virus identified
Primary code for confirmed COVID-19 cases with positive test results.
Contact with and (suspected) exposure to other viral communicable diseases
Used for suspected exposure to COVID-19 without a confirmed diagnosis.
Personal history of other infectious and parasitic diseases
Used for documenting a history of resolved COVID-19 infection.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| U07.1 | COVID-19, virus identified | Use when there is a confirmed COVID-19 diagnosis with a positive test result. |
|
| Z20.828 | Contact with and (suspected) exposure to other viral communicable diseases | Use when there is suspected exposure to COVID-19 without a confirmed diagnosis. |
|
| Z86.19 | Personal history of other infectious and parasitic diseases | Use for documenting a history of resolved COVID-19 infection. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for COVID-19 positive
Essential facts and insights about COVID-19 Positive
Primary ICD-10-CM Codes for covid positive
Decision Criteria
clinical Criteria
- Positive COVID-19 test and provider documentation
Applicable To
- Confirmed COVID-19 infection
Excludes
- Suspected COVID-19 without confirmation
Clinical Validation Requirements
- Positive PCR or antigen test
- Provider documentation of COVID-19 diagnosis
Code-Specific Risks
- Incorrectly coding asymptomatic positive cases without provider confirmation
Coding Notes
- Ensure provider confirmation for asymptomatic cases before coding U07.1.
Z20.828 - Contact with and (suspected) exposure to other viral communicable diseases
Use when there is suspected exposure to COVID-19 without a confirmed diagnosis.
Applicable To
- Suspected exposure to COVID-19
Excludes
- Confirmed COVID-19 infection
Clinical Validation Requirements
- Documented exposure to COVID-19
Coding Notes
Do not use for confirmed COVID-19 cases.
Z86.19 - Personal history of other infectious and parasitic diseases
Use for documenting a history of resolved COVID-19 infection.
Applicable To
- History of resolved COVID-19 infection
Excludes
- Active COVID-19 infection
Clinical Validation Requirements
- Documented history of resolved COVID-19
Coding Notes
Ensure the infection is resolved before using this code.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Other viral pneumonia
J12.89Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Exposure to COVID-19
Z20.828Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting COVID-19 Positive to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code U07.1.
Impact
Clinical: Misrepresentation of patient condition., Regulatory: Non-compliance with coding standards., Financial: Potential audit risks and reimbursement issues.
Mitigation Strategy
Always query provider for confirmation., Ensure documentation supports coding.
Impact
Reimbursement: Incorrect coding can affect DRG assignment., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate data representation.
Mitigation Strategy
Query provider; use Z03.818 if unresolved.
Impact
Coding U07.1 without provider confirmation can trigger audits.
Mitigation Strategy
Ensure provider confirmation is documented.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for COVID-19 Positive, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for COVID-19 Positive
Use these documentation templates to ensure complete and accurate documentation for COVID-19 Positive. These templates include all required elements for proper coding and billing.
COVID-19 Positive Admission
Specialty: Internal MedicineRequired Elements
- Positive test result
- Symptoms
- Provider diagnosis
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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