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Wiki Dx Code Z20.828

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The patient presents with flu-like symptoms/viral symptoms(fever, cough, and headache) and has no known exposure to Covid. During the visit, the patient was not tested for Covid and no tests have been ordered. Physician has just provided the covid-19 hotline number and documented the final impression as "Suspected Covid-19 Infection."

Can we code only Z20.828 (Contact with or suspected exposure to other viral communicable disease) or code Z20.828 along with the above-mentioned symptoms.

It would really be helpful if this clarified.

Thank you.

thomas7331

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As per the official guidelines, under the Chapter 21 section, the use of the Z20 codes is addressed as follows:

Category Z20 indicates contact with, and suspected exposure to, communicable diseases. These codes are for patients who do not show any sign or symptom of a disease but are suspected to have been exposed to it by close personal contact with an infected individual or are in an area where a disease is epidemic.

The AHA has also issued this additional guidance on this code specific to COVID-19:

Code Z20.828, 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. According to guideline I.C.21.c.1 Contact/Exposure, Z20 codes may be used for patients who are in an area where a disease is epidemic. Therefore, due to the current COVID-19 pandemic, when a patient presents with signs/symptoms associated with COVID-19 and is tested for the virus because the provider suspects the patient may have COVID-19, code Z20.828 may be assigned without explicit documentation of exposure or suspected exposure.

(see: https://www.aha.org/fact-sheets/2020-03-30-frequently-asked-questions-regarding-icd-10-cm-coding-covid-19)
 
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So if the patients presents to the clinic for cough. There is no documentation that the patient has been exposed to COVID19, Dr. does not document that he suspects the patient has COVID19 and Dr doesn't run test for COVID, it is inappropriate to use dx code Z20.828?
 

thomas7331

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So if the patients presents to the clinic for cough. There is no documentation that the patient has been exposed to COVID19, Dr. does not document that he suspects the patient has COVID19 and Dr doesn't run test for COVID, it is inappropriate to use dx code Z20.828?
Correct. It is always inappropriate to use a code that is not supported by a documented statement by the provider in the record of the encouter.
 
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