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U07.1
ICD-10-CM
COVID-19 Infection

Find comprehensive information on COVID-19 Infection diagnosis, including clinical documentation, medical coding, and healthcare guidance. Learn about Coronavirus Disease 2019 and SARS-CoV-2 Infection, covering symptoms, testing, treatment, and ICD-10 codes for accurate reporting. This resource supports healthcare professionals in proper COVID-19 diagnosis documentation and coding practices.

Also known as

Coronavirus Disease 2019
SARS-CoV-2 Infection

Diagnosis Snapshot

Key Facts
  • Definition : Viral respiratory illness caused by SARS-CoV-2.
  • Clinical Signs : Fever, cough, shortness of breath, fatigue, loss of taste or smell.
  • Common Settings : Community-acquired, travel-related, close contact exposure.

Related ICD-10 Code Ranges

Complete code families applicable to AAPC U07.1 Coding
U07.1

COVID-19, virus identified

Confirmed COVID-19 infection caused by the SARS-CoV-2 virus.

U07.2

COVID-19, virus not identified

Clinically diagnosed COVID-19 where the virus hasnt been confirmed by lab test.

J12.81

Pneumonia due to COVID-19

Lung inflammation specifically caused by the COVID-19 infection.

B97.29

Other coronavirus as the cause of diseases classified elsewhere

Coronavirus infections causing conditions classified under other categories.

Code-Specific Guidance

Decision Tree for

Follow this step-by-step guide to choose the correct ICD-10 code.

Is the COVID-19 infection confirmed?

  • Yes

    Is pneumonia present?

  • No

    Is COVID-19 suspected?

Code Comparison

Related Codes Comparison

When to use each related code

Description
COVID-19 viral infection
Influenza viral infection
Acute respiratory infection

Documentation Best Practices

Documentation Checklist
  • Document COVID-19 symptoms: fever, cough, shortness of breath.
  • Record symptom onset date for accurate COVID-19 diagnosis coding.
  • Specify COVID-19 diagnostic test type and results (PCR, antigen).
  • Document COVID-19 disease severity (mild, moderate, severe).
  • Note any COVID-19 related complications or comorbidities.

Coding and Audit Risks

Common Risks
  • Unspecified COVID-19

    Coding COVID-19 without specifying confirmed, suspected, or ruled out status can lead to inaccurate reporting and reimbursement.

  • Comorbidity Coding

    Accurate capture of comorbidities with COVID-19 is crucial for risk adjustment and severity reflection. Missing codes impacts quality metrics.

  • Sequencing Errors

    Incorrect sequencing of COVID-19 with other diagnoses can affect DRG assignment and reimbursement, especially with respiratory conditions.

Mitigation Tips

Best Practices
  • Isolate immediately to prevent COVID-19 transmission. Document isolation status.
  • Ensure accurate COVID-19 diagnosis codes (U07.1, U07.2) for proper reimbursement.
  • Follow current CDC guidelines for COVID-19 testing and treatment protocols.
  • Monitor patient symptoms and document disease severity for accurate coding.
  • Implement infection control measures. Adhere to healthcare compliance regulations.

Clinical Decision Support

Checklist
  • Verify patient symptoms: fever, cough, shortness of breath, loss of taste/smell (ICD-10 U07.1, U07.2)
  • Confirm with PCR or antigen test (CPT 87635, 87426). Document test type/result.
  • Assess severity: mild, moderate, severe, critical (e.g., oxygen saturation, respiratory rate).
  • Review comorbidities: document underlying conditions (e.g., diabetes, hypertension) impacting prognosis.

Reimbursement and Quality Metrics

Impact Summary
  • COVID-19 reimbursement impacts: Diagnosis coding (ICD-10-CM U07.1) accuracy crucial for maximizing claim acceptance, minimizing denials.
  • Coding quality metrics: Accurate COVID-19 diagnosis coding impacts hospital case mix index (CMI), affecting Medicare reimbursement.
  • Hospital reporting: COVID-19 infection data reporting accuracy essential for public health surveillance, resource allocation.
  • Medical billing: Proper documentation and coding (U07.1) ensure correct COVID-19-related reimbursement for testing, treatment.

Streamline Your Medical Coding

Let S10.AI help you select the most accurate ICD-10 codes for . Our AI-powered assistant ensures compliance and reduces coding errors.

Frequently Asked Questions

Common Questions and Answers

Q: What are the most current evidence-based guidelines for managing severe COVID-19 infection in hospitalized patients, including ventilator management and thromboembolism prophylaxis?

A: Managing severe COVID-19 infection requires a multifaceted approach based on the most up-to-date clinical guidelines. For hospitalized patients, oxygen supplementation is crucial, with mechanical ventilation considered for those with worsening hypoxemic respiratory failure. Current recommendations emphasize lung-protective ventilation strategies, including low tidal volumes and optimal PEEP settings, to minimize ventilator-induced lung injury. Thromboembolism prophylaxis is another cornerstone of severe COVID-19 management. Guidelines recommend pharmacologic prophylaxis, such as low-molecular-weight heparin, for most hospitalized patients, unless contraindicated. Additionally, corticosteroids like dexamethasone have shown benefit in reducing mortality in patients requiring supplemental oxygen. Explore how our platform integrates real-time updates on COVID-19 management guidelines to ensure optimal patient care.

Q: How can clinicians differentiate between COVID-19 pneumonia and other viral or bacterial pneumonias using clinical presentation, laboratory findings, and imaging studies, and when should I suspect co-infection?

A: Differentiating COVID-19 pneumonia from other respiratory infections can be challenging due to overlapping symptoms. While clinical presentation may include fever, cough, and shortness of breath common to many respiratory illnesses, some features may raise suspicion for COVID-19, such as loss of taste or smell. Laboratory findings, including PCR testing for SARS-CoV-2, are essential for definitive diagnosis. Imaging studies, particularly chest CT scans, can reveal characteristic ground-glass opacities or consolidations often seen in COVID-19 pneumonia, but these findings are not always specific. Co-infection with other bacterial or viral pathogens can occur in COVID-19 patients and should be suspected in individuals with atypical presentations or worsening clinical course. Consider implementing a comprehensive diagnostic approach that incorporates clinical findings, laboratory testing, and imaging to accurately differentiate COVID-19 pneumonia and identify potential co-infections. Learn more about the diagnostic tools available to enhance your clinical decision-making in respiratory infections.

Quick Tips

Practical Coding Tips
  • Code COVID-19 with U07.1
  • Document symptom details
  • Query physician for clarity
  • Check for personal history
  • Review ICD-10 guidelines

Documentation Templates

Patient presents with complaints consistent with COVID-19 infection, also known as Coronavirus Disease 2019 and SARS-CoV-2 infection.  Symptoms onset began [Date of symptom onset] and include [List specific symptoms e.g., cough, fever, shortness of breath, fatigue, loss of taste or smell, body aches, sore throat, headache, congestion or runny nose, nausea or vomiting, diarrhea].  Patient reports [mention any relevant exposures, recent travel, or contact with known COVID-19 cases].  Vital signs recorded as temperature [Temperature] degrees Fahrenheit, heart rate [Heart Rate] bpm, respiratory rate [Respiratory Rate] breaths per minute, blood pressure [Blood Pressure] mmHg, and oxygen saturation [Oxygen Saturation]% on room air.  Physical examination reveals [Document relevant physical findings e.g., clear lung sounds, mild pharyngeal erythema].  Differential diagnoses considered include influenza, other viral respiratory infections, and pneumonia.  Based on presenting symptoms, exposure history, and clinical findings, a presumptive diagnosis of COVID-19 is made.  A SARS-CoV-2 PCR test was ordered.  Patient advised on supportive care including rest, hydration, and over-the-counter medications for symptom management such as acetaminophen or ibuprofen for fever and body aches.  Patient educated on isolation precautions, including quarantine guidelines per CDC recommendations, to prevent further transmission.  Follow-up scheduled for [Date of follow-up] to review test results and assess symptom progression.  ICD-10-CM code U07.1 is documented for COVID-19.  Treatment plan documented and communicated to the patient.  Medical billing and coding reviewed for accuracy.