Latest and Greatest 2022 COVID-19 Code Updates
Becky Buegel, RHIA, CDIP, CHP Outpatient Coding Leave a Comment
On December 8, 1941, President Franklin D. Roosevelt declared, “… December 7, 1941 – a day that will live in infamy….” when the USA was suddenly attacked by Japan. Many died from the attack itself and the ensuing world war into which America was thrust. On March 11, 2020, WHO declared COVID-19 a global pandemic (an infectious disease that has spread, in this case, worldwide.) One has to almost wonder if, years from now, March 11, 2020 could be likened to a “day of infamy” based on the resulting years-long affect COVID-19 has had on our world. The entire world, in essence, has been attacked by COVID-19.
ICTV identified and named the virus “severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in February 2020. The virus is genetically related to the coronavirus blamed for the 2003 SARS outbreak.
WHO named this new disease COVID-19, using previously developed guidelines from the World Organization for Animal Health, and the Food and Agriculture Organization of the United Nation.
Tracking the who, what, where, when, etc. of the COVID-19 pandemic has become an essential task in an effort to stop it in its tracks, but also to identify what can be done to prevent future, similar pandemics. One of the most important tools in tracking this pandemic has been through the ICD-10 coding and reporting system. Though of course it seems like an exaggeration to say that there have been daily changes to the ICD-10-CM and ICD-10-PCS coding systems here in the USA, it’s almost not! New codes, along with coding advice, have bombarded healthcare providers/coders rapidly and furiously.
The ICD-10 Coordination and Maintenance Committee, as every coder knows, is a Federal interdepartmental committee tasked with maintaining ICD-10. Comprised by both the NCHS and CMS, the C&M Committee meets twice annually. NCHS has primary responsibility for ICD-10-CM, and CMS has primary responsibility for ICD-10-PCS.
At its meeting in September, 2021, the C&M Committee announced a joint decision between CMS and the CDC to update ICD-10 codes on a semi-annual basis; code updates will be implemented on April 1st each year in addition to the October 1st fiscal year updates. On November 22, 2021, CMS and the CDC revealed three (3) new COVID-19-related diagnosis codes and seven (7) ICD-10-PCS codes; the new codes will be effective with discharges/visits on/after April 1, 2022. It should be noted that none of the PCS codes are considered DRG operating room procedures.
The AMA has been busy updating and streamlining reporting of COVID-19 immunizations in its CPT® coding system. The CPT® Editorial Panel has sanctioned 28 new Category I codes, and revised parenthetical notes as well as guidelines, and updated Appendix Q. Working closely with CMS and the CDC, the new CPT® codes incorporate each of the four coronavirus vaccines in addition to administration codes for each vaccine and dose. The new codes will allow for better tracking, reporting, and data analysis.
The AMA has seemingly worked overtime to provide tools and other information that will help coder identify the proper CPT® codes to assign for COVID-19 vaccines. Other companies/organizations seem to have followed suit. Listed below are URLs for sites that coders can (and should!) review for further information for not only CPT® but also HCPCS and ICD-10 code assignments.
As a coder, when it comes to assigning CPT and ICD-10 codes for COVID-19 there’s only one thing you can truly count on: Just when you think you know it, they change it!
SUMMARY:
COVID-19 just seemingly doesn’t want to give up and go away. Tracking the virus and its mutation(s) is very important world-wide. New ICD-10-CM and ICD-10-PCS codes have been created, some of which will be implemented for the first time beginning in April, 2022. New CPT codes associated with COVID-19 are also set for 2022 implementation. This blog addresses the new codes and provides coders with a variety of resources to stay on top of current and upcoming changes.
REFERENCES:
https://www.cdc.gov/museum/timeline/covid19.html
https://journal.ahima.org/get-the-2022-cpt-code-updates-for-covid-19-and-more/
CODING UPDATE RESOURCES
URL |
TITLE/INFORMATION |
ORGANIZATION |
COVID-19 Coding and Reporting Information New CPT ®, HCPCS, and ICD-10 CM Codes |
ASCO |
|
https://www.ama-assn.org/practice-management/cpt/covid-19-immunization-administration-and-em-visits |
COVID-19 Immunization Administration and E/M Visits |
AMA |
Find your COVID-19 Vaccine CPT® Codes |
AMA |
|
https://www.cms.gov/medicare/covid-19/medicare-billing-covid-19-vaccine-shot-administration |
Medicare Billing for COVID-19 Vaccine Shot Administration (aka Provider Tool Kit) |
CMS |
https://www.ama-assn.org/system/files/2021-01/covid-19-immunizations-appendix-q-table.pdf |
Appendix Q: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) Vaccines |
AMA |
https://www.ama-assn.org/system/files/cpt-assistant-guide-coronavirus-november-2021.pdf |
CPT® Assistant Special Edition: November Update – New COVID-19 Code: November Update |
AMA |
https://www.ama-assn.org/system/files/2021-04/covid-19-immunization-em-visits-guide.pdf |
COVID-19 Immunization Administration and Evaluation and Management Visits |
AMA |
COVID-19 CPT® Guidance |
AMA |
|
https://www.ama-assn.org/practice-management/cpt/covid-19-cpt-vaccine-and-immunization-codes |
COVID-19 Vaccine and Immunization Codes |
AMA |
https://www.ama-assn.org/system/files/covid-vaccine-long-descriptors.pdf |
CPT ® Category I New SARS-CoV-2 Vaccine Codes Long Descriptors |
AMA |
https://www.ama-assn.org/system/files/covid-vaccine-medium-descriptors.pdf |
CPT ® Category I New SARS-CoV-2 Vaccine Codes Medium Descriptors |
AMA |
https://www.ama-assn.org/system/files/covid-vaccine-short-descriptors.pdf |
CPT ® Category I Knew SARS-CoV-2 Vaccine Codes Short Descriptors |
AMA |
https://www.ama-assn.org/practice-management/cpt/covid-19-cpt-coding-and-guidance |
COVID-19 Coding and Guidance |
AMA |
New ICD-10-CM code for Post-COVID Conditions, following the 2019 Novel Coronavirus (COVID-19) |
CDC |
|
International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) – Scroll down for information on the April 2022 Release of ICD-10-CM |
CDC/NCHS |
|
2022 ICD-10-PCS – COVID Update |
CMS |
|
ICD-10-PCS OGCR – Updated 12/1/21 |
CMS |
|
ICD-10-CM OGCR – 04/01/22 Update |
|
|
SOME INFORMATION MAY BE REDUNDANT; SOME INFORMATION MAY BE OUTDATED AS CHANGES ARE OCCURRING RAPIDLY. ALWAYS CHECK TO SEE IF UPDATES HAVE BEEN MADE BEFORE RELYING ON WHAT IS NOTED.
|
ICD-10-CM/PCS APRIL 1, 2022 UPDATES
ICD-10-CM CODE |
DESCRIPTION |
Z28.310 |
Unvaccinated for COVID-19 |
Z28.311 |
Partially vaccinated for COVID-19 |
Z28.39 |
Other underimmunization status |
NOTE: None of these new diagnosis codes has CC/MCC status.
ICD-10-PCS CODE |
DESCRIPTION |
XW013V7 |
Introduction of COVID-19 vaccine dose 3 into subcutaneous tissue, percutaneous approach, new technology group 7 |
XW013W7 |
Introduction of COVID-19 vaccine booster into subcutaneous tissue, percutaneous approach, new technology group 7 |
XW023V7 |
Introduction of COVID-19 vaccine dose 3 into muscle, percutaneous approach, new technology group 7 |
XW023W7 |
Introduction of COVID-19 vaccine booster into muscle, percutaneous approach, new technology group 7 |
XW0DXR7 |
Introduction of fostamatinib into mouth and pharynx, external approach, new technology group 7 |
XW0G7R7 |
Introduction of fostamatinib into upper GI, via natural or artificial opening, new technology group 7 |
XW0H7R7 |
Introduction of fostamatinib into lower GI, via natural or artificial opening, new technology group 7 |
NOTE: None of these new procedure codes are identified as a DRG operating room procedure.
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