News: COVID-19 ICD-10-CM code coming April 1, CMS releases provider waiver fact sheet

The Centers for Disease Control and Prevention (CDC) announced during the March 18 ICD-10-CM Coordination and Maintenance Committee meeting that a new code specifically for reporting COVID-19 will be available for use starting on April 1, 2020. The code will be housed in Chapter 22, Codes for special purposes (U00-U85) as follows:

Provisional assignment of new diseases of uncertain etiology or emergency

                        Use (U00-U-49)

Add      Note: Codes U00-U49 are to be used by WHO for the provisional assignment of new diseases of uncertain etiology.

            U07 Conditions of uncertain etiology

New code        U07.1 COVID-19

Add                  Use additional code to identify pneumonia or other manifestation

Add                  Excludes1: Coronavirus infection, unspecified site (B34.2)

Add                                    Coronavirus as the cause of diseases classified to other
                                          chapters (B97.2-)

Add                  Severe acute respiratory syndrome (SARS), unspecified (J12.81)

Additionally, CMS has released a fact sheet for healthcare providers during the COVID-19 emergency declaration. In the fact sheet, CMS says that “in response to COVID-19, [they] are empowered to take proactive steps through 1135 waivers and rapidly expand the [Trump] Administration’s aggressive efforts against COVID-19.”

Notably, for critical access hospitals, CMS is waiving the requirements that they limit the number of beds to 25, and that the length of stay be limited to 96 hours.

CMS is waiving requirements to allow acute care hospitals to house acute care inpatients in excluded distinct part units, where the distinct part unit’s beds are appropriate for acute care inpatient. “The Inpatient Prospective Payment System (IPPS) hospital should bill for the care and annotate the patient’s medical record to indicate the patient is an acute care inpatient being housed in the excluded unit because of capacity issues related to the disaster or emergency,” according to the fact sheet.

The fact sheet also includes information for skilled nursing facilities, durable medical equipment, care for excluded inpatient rehabilitation and psychiatric unit patients, home health, and other situations. The full fact sheet can be found here.