Wiki Coding for asymptomatic COVID Positive Patients

[CBumpus]

We have patients that are testing positive for COVID-19 but are asymptomatic. How would you code for this? We have received denials for U07.1 so that code doesn't seem to be working for us. We are a CHC setting up tents citywide offering isolation and quarantine for homeless patients. But when their test results come back positive, we have to send them to a separate COVID+ facility. Just wondering what others are doing in this scenario.

Thanks!

 

[thomas7331]

The guidance where I work has been to use U07.1 if the test results are positive. I'm not aware of any denial issues, but this is a new code that was only effective on April 1, so it is early to be seeing denials already. If you were using that code on claims with dates of service prior to 4/1/2020, that could be the reason since it was not yet in effect and would not be valid code for those claims. Otherwise, it could also be that some payers may not have yet updated their systems with the appropriate new codes and benefits.

 

[CBumpus]

Thank you Thomas. I will ask our billing department to resubmit those claims with DOS past 4/1 again. It might be that the clearinghouse is not updated to support the code. Also, for COVID positive cases prior to 4/1, how would you code that?

 

[thomas7331]

Thank you Thomas. I will ask our billing department to resubmit those claims with DOS past 4/1 again. It might be that the clearinghouse is not updated to support the code. Also, for COVID positive cases prior to 4/1, how would you code that?

For dates of service prior to 4/1/2020, our guidance has been to code the related disease or symptom with which the patient has presented (e.g. J12.9 for viral pneumonia) followed by B97.29 - Other coronavirus as the cause of diseases classified elsewhere for the COVID-19.