Wiki COVID 19 - Z CODES

ladymatthew

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Hi everyone ! need some guidance...... I code facility ED records and i am having a hard time interpreting the guidelines correctly for reporting the Zcodes for exposure to Novel 2019 Corona Virus. It appears to me that both Z20.828 and Z03.818 require that testing be done (labwork) in order to report the code (whether or not a positive or negative result) how do you then report a dx of exposure to COVID 19 when the patient presents symptomatic and no testing was done, the provider just instructed them to quarantine. My director indicates this should be reported as Z20.828 but the guidance i have reads that this code should be reported when- Contact with and (suspected) exposure to other viral communicable diseases, should be used if a patient has a known or suspected exposure to COVID-19, is exhibiting signs/symptoms associated with COVID-19, and the test results are negative, inconclusive, or unknown. so again my question..... how do you report this if there is no testing done?
 
I see what you are saying but I would not take the guideline quite so literally. My interpretation of the phrase "test results are negative, inconclusive, or unknown" does not mean that the patient must have been tested, but rather that the record does not contain documentation that the condition was confirmed by testing. The normal use of this code category is not limited just to conditions that are being tested, but to any cases where a diagnosis is not confirmed in the course of the encounter.

So if the patient was not tested, then by default we know that the patient's COVID-19 status is unknown. So in that case the Z20.828 would still be coded correctly if the provider did document the exposure but was not able to not confirm a diagnosis. The code would only drop off if there is documentation of a positive result.
 
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