KMA Special Advisory and Resources for Members: COVID-19/Coronavirus

Posted March 9, 2020

The KMA is continuing to monitor the spread of COVID-19, more commonly referred to as Coronavirus, as new details emerge. Physicians are urged to follow guidance from the Kentucky Cabinet for Health and Family Services and the Centers for Disease Control.

Kentucky Public Health Commissioner Steven Stack, M.D. has prepared the following special video message for KMA members regarding the virus.

Coding Reminders for Coronavirus

Coding for COVID-19 doesn’t involve new codes or require learning new coding conventions. Physicians should follow these current guidelines:

1. Code for confirmed conditions
2. Use the presenting coding in the first position on the claim form (pneumonia, bronchitis, etc.)
3. Use the code for coronavirus in the second position

Pneumonia, confirmed as due to COVID-19
J12.89: other viral pneumonia
B97.29: other coronavirus as the cause of diseases classified elsewhere

Acute bronchitis, confirmed as due to COVID-19
J20.8: acute bronchitis due to other specified organisms
B97.29: other coronavirus as the cause of diseases classified elsewhere

Bronchitis, not specified as chronic or acute, confirmed as due to COVID-19
J40: bronchitis, not specified as acute or chronic
B97.29: other coronavirus as the cause of diseases classified elsewhere

Lower respiratory infection, confirmed as due to COVID-19
J22: unspecified acute lower respiratory infection
B97.29: other coronavirus as the cause of diseases classified elsewhere

or

J98.8: other specified respiratory infection
B97.29: other coronavirus as the cause of diseases classified elsewhere

Cases with acute respiratory distress syndrome (ARDS), confirmed as due to COVID-19
J80: acute respiratory distress syndrome
B97.29: other coronavirus as the cause of diseases classified elsewhere

Other Reminders:

• If the physician has not confirmed the condition as being due to this new coronavirus, do not use B97.29. Use the condition (pneumonia, bronchitis, or symptom or symptoms such as cough, fever, shortness of breath) in the first position.
• If the patient has been exposed to someone who is confirmed to have had COVID-19, use Z20.828: contact with and (suspected) exposure to other viral communicable diseases.
• If the COVID-19 virus is suspected but testing does not confirm that the patient has the disease, use the confirmed diagnosis such as bronchitis or assignment symptom such as cough, and add Z03.818: encounter for observation for suspected exposure to other biological agents ruled out.

Anthem Announces Waiver for Coronavirus Testing

Anthem, Inc., announced that it will eliminate additional costs for members in its affiliated health plans by providing coverage of the coronavirus screening test at no out-of-pocket-cost. The company also confirmed that prior authorization is not required for diagnostic services related to COVID-19 testing. It is also encouraging members to utilize telehealth when possible and for members who have a pharmacy benefit plan to consider asking for 90-day supplies of medications.

The announcement and additional details are available here.