Wiki Documented suspicion for Z20.822

[lizbeth.grace]

I'm thought farming here for the use of Z20.822, Contact with and (suspected) exposure to COVID-19. If a symptomatic patient comes into the ED and has a COVID test performed, is it reasonable to consider the performance of the test to be the provider's suspicion of exposure? Or do you think the suspected exposure needs to be specifically documented?

 

[natashalage]

Hello,
I am not an expert yet. My thoughts are: I would code the symptoms and Z20.822- Only if MD documented that pt was in contact with COVID positive person, exposed, around etc.

 

[iowagirl77]

If they were symptomatic but the test was negative, I'd code just the symptoms.

Reference: https://www.jucm.com/icd-10-cm-whats-new-for-2024/
Asymptomatic individuals with actual or suspected exposure to COVID-19 should be reported with code Z20.822, contact with and (suspected) exposure to COVID-19. This test is not a screening as it is medically necessary. It is important that providers understand the distinction as insurance plans do not have to cover screenings, so this should be considered a cash pay service. Claims for exposure would generally be reimbursed by most insurance plans.

Also, avoid the use of the word “screening” if the reason for the visit does not meet the definition of a screening above. Use of the word “screening” while the patient has been exposed or is even symptomatic may result in a recoupment or denial on payer review.

If the patient is symptomatic and tests negative for COVID-19, be sure to report the symptoms to support medical necessity for the visit.

 

[TThivierge]

I'm thought farming here for the use of Z20.822, Contact with and (suspected) exposure to COVID-19. If a symptomatic patient comes into the ED and has a COVID test performed, is it reasonable to consider the performance of the test to be the provider's suspicion of exposure? Or do you think the suspected exposure needs to be specifically documented?

Hi Lizbeth,
I agree with Iowagirl, use those symptoms R05, J98.8, R09.81 or??????whatever doc has down for his attestation, then dx Z11.52 or Z20.822 that fits documentation given. If access to results and positive for COVID 19 add dx U07 or U09 as primary then Z dx code.
Lady T