Guidance for ICD Coding for COVID-19 Disease Claims

Ohio Bureau of Workers' Compensation sent this bulletin at 06/19/2020 07:45 AM EDT

Guidance for ICD Coding for COVID-19 Disease Claims

Please consider the following guidance for determining the proper International Classification of Diseases (ICD) code to use when reporting workers' compensation claims for COVID-19 to BWC. Please provide the appropriate code along with your certification decision at the time you report the claim to BWC.

COVID-19 Coding for Confirmed Diagnosis

U07.1 is assigned to a disease diagnosis of COVID-19 confirmed by laboratory testing or, in the absence of a positive COVID-19 test, diagnosis of COVID-19 by the treating physician.

If COVID-19 was diagnosed, the assignment would be U07.1, even if the claim is being contested.

U07.2 DO NOT USE. This code is not used in the United States.

When considering allowances in situations where the injured worker has other respiratory symptoms before or at the same time as COVID-19, you should assign both conditions. As an example, if COVID-19 is documented as being associated with acute respiratory distress syndrome (ARDS), the claim should be assigned both J80 for ARDS and U07.1 for COVID-19.

COVID-19 Exposure Only (No Diagnosis of COVID-19) Coding Tips

Assign T75.89XA when the injured worker was exposed to COVID-19 but was not diagnosed COVID-19 through testing or by a treating physician. In these cases, either the injured worker’s COVID-19 test results are negative, or the injured worker was not tested. Additionally, while the injured worker may have had symptoms, the treating physician did NOT diagnose the injured worker with COVID-19 .

Other Coronavirus Coding Tips

Assign B97.29 to other coronaviruses, such as the flu. DO NOT use B97.29 when there is a confirmed diagnosis of COVID-19. B97.29 is ONLY used for all coronaviruses other than COVID-19.