Wiki "Presumed positive" Covid 19

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How are you suppose to code a "presumed positive" without the documentation of a test being preformed? I have an NP note that states a patient is "presumed positive" because she is in the same area as other confirmed cases. In that case, wouldn't I just use the Z20.828 code because she was not tested but was exposed and is most likely to have the virus?
Please HELP!
 
I would query the provider about this because language is confusing. A 'presumptive positive' test, per the AHA, "means an individual has tested positive for the virus at a local or state level, but it has not yet been confirmed by the CDC". If that's the case, then it should be coded as a confirmed COVID-19 diagnosis. A 'presumed' diagnosis is something different, which is coded as an uncertain or unconfirmed diagnosis, and if no testing has actually been done, then the COVID-19 should not be coded. It isn't clear to me, from what you've said above, which of these the provider is stating.
 
Okay, so there is more clarification. This quote was taken directly from an NP note "SNF per DOH recommendations has stopped testing members on his unit d/t high number of positives, with the direction that if there are additional symptomatic residents they could be presumed positive."
 
Yes, then it would not be 'presumptive positive' test if the patient is not even tested. In that case I would treat it as an uncertain diagnosis and not code it (for outpatient or physician encounters) since it is not a confirmed diagnosis.
 
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