New diagnosis codes related to COVID-19 take effect in 2021

By Erin Stephens, AuntMinnie.com contributing writer

February 24, 2021 -- Most of the annual changes to diagnosis coding under ICD-10 system take effect on October 1, but other changes occur during the year. There are quite a few codes that became effective on January 1, 2021, all related to COVID-19 conditions.

Erin Stephens of Healthcare Administrative Partners
Erin Stephens of Healthcare Administrative Partners.

Most of the annual changes to diagnosis coding under ICD-10 system take effect on October 1, but other changes occur during the year. There are quite a few codes that became effective on January 1, 2021, all related to COVID-19 conditions.

When COVID-19 is the principal diagnosis, U07.1 COVID-19 should be sequenced first as the primary diagnosis, except when other guidelines (such as obstetrics, sepsis, or transplant complications) require that those guidelines be listed first, as we discussed in our recent article. Additional codes are used to identify other manifestations. The following are new codes to be used along with the U07.1 COVID-19 diagnosis as of January 1, 2021:


Description Code
Pneumonia due to COVID-19 J12.82
Multisystem inflammatory syndrome (MIS) with COVID-19 M35.81
Other specified systemic involvement of connective tissue with COVID-19 M35.89

For a patient with multisystem inflammatory syndrome (MIS) (M35.81) as the primary diagnosis, additional codes related to COVID-19 are available as follows:

Description Code
Sequelae of COVID-19 B94.8
Personal history of COVID-19 Z86.16
Contact with and (suspected) exposure to COVID-19 or SARS-CoV-2 Z20.822

In our annual update, we reported that the code Z20.828, "Contact with and (suspected) exposure to other viral communicable diseases," would be used for an asymptomatic patient who experienced actual or suspected exposure to COVID-19. The addition of new code Z20.822 changes that definition somewhat, as clarified below.

  • Z20.822, "Contact with and (suspected) exposure to COVID-19 or SARS-CoV-2," is to be used when COVID-19 has not been ruled out, and
  • Z20.828 is to be used when COVID-19 has been ruled out.

When other signs or symptoms are present, they are listed first with Z20.828 or Z20.822 listed additionally.

We previously reported that Z86.19, "Personal history of other infectious and parasitic diseases," could be used when seeing patients who have recovered from COVID-19, but now there is a more specific code, Z86.16 "Personal history of COVID-19." When it is appropriate, Z09, "Encounter for follow-up examination after completed treatment for conditions other than malignant neoplasm," can still be used.

COVID testing performed during the preoperative screening process is to code using Z11.52 Encounter for screening for COVID-19.

Erin Stephens is senior client manager, education at Healthcare Administrative Partners.

The comments and observations expressed are those of the author and do not necessarily reflect the opinions of AuntMinnie.com.


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