Find information on COVID-19 testing, including SARS-CoV-2 test, Coronavirus test, and COVID screening. This resource provides details for healthcare professionals on clinical documentation and medical coding related to a COVID-19 diagnosis. Learn about proper coding procedures and documentation requirements for COVID-19 tests for accurate healthcare reporting and reimbursement.
Also known as
COVID-19, virus identified
Confirmatory test indicating presence of COVID-19 virus.
Encounter for screening for other viral diseases
Encounters for COVID-19 testing when no symptoms are present.
Contact with and exposure to other viral communicable diseases
Possible exposure to COVID-19 prompting testing.
Follow this step-by-step guide to choose the correct ICD-10 code.
Is the COVID-19 test for diagnostic purposes?
Yes
Is the test positive?
No
Is the test for antibody status?
When to use each related code
| Description |
|---|
| Tests for active COVID-19 infection. |
| Detects past COVID-19 infection. |
| Quantifies antibodies against SARS-CoV-2. |
Coding requires specifying PCR, Antigen, or Antibody test for accurate reimbursement and data analysis. COVID-19 test alone is insufficient.
Missing documentation of medical necessity, signs/symptoms, or test ordering rationale can lead to claim denials and compliance issues.
Using unlisted or unspecified codes when a specific code exists for the COVID-19 test type may trigger audits and payment delays.
Q: What are the most reliable COVID-19 test options for differentiating between acute infection and past exposure in symptomatic patients with comorbidities?
A: When diagnosing COVID-19 in symptomatic patients with comorbidities, it's crucial to differentiate between acute infection and past exposure. While PCR tests remain the gold standard for detecting active SARS-CoV-2 infection, their sensitivity can wane in the later stages of infection. For patients presenting with symptoms weeks after initial exposure, a combination of PCR and antibody testing may be considered to assess both current infection status and prior immune response. Furthermore, the patient's clinical presentation, including symptom onset and duration, along with underlying comorbidities, should be carefully evaluated in conjunction with test results to guide appropriate management. Explore how incorporating antigen tests can improve triage efficiency in patients with suspected acute COVID-19 infection.
Q: How can clinicians interpret discordant COVID-19 test results (e.g., positive PCR, negative antigen) in a patient suspected of having the Omicron variant?
A: Discordant COVID-19 test results, such as a positive PCR and negative antigen test, can present a diagnostic challenge, especially with the emergence of variants like Omicron. Several factors contribute to this discrepancy, including viral load, test sensitivity, and the timing of sample collection. A negative antigen test does not necessarily rule out COVID-19 infection in a symptomatic patient with a positive PCR. Given Omicron's rapid transmission and potential for immune escape, clinicians should consider repeat testing, preferably PCR, within 24-48 hours, alongside a thorough clinical assessment. Consider implementing standardized testing protocols for optimal interpretation of COVID-19 test results in the context of emerging variants. Learn more about the latest CDC guidelines on COVID-19 testing and variant surveillance.
Patient presents for COVID-19 evaluation due to [reason for testing, e.g., symptoms, exposure, pre-procedural screening]. Symptoms, if present, include [list specific symptoms e.g., cough, fever, shortness of breath, anosmia, ageusia, fatigue, body aches, headache, sore throat, congestion, nausea, vomiting, diarrhea]. Onset of symptoms was [date of symptom onset or "asymptomatic"]. Patient reports [mention relevant travel history, exposures, or pertinent negatives e.g., recent travel to high-risk areas, close contact with confirmed COVID-19 case, no known exposures]. Physical examination reveals [document vital signs e.g., temperature, heart rate, respiratory rate, oxygen saturation, and pertinent findings e.g., clear lung sounds, no respiratory distress]. Assessment: Suspected COVID-19 infection. Plan: SARS-CoV-2 testing via [specify test type e.g., nasopharyngeal swab, PCR, antigen] performed. Patient education provided regarding isolation precautions, symptom management, and follow-up care. Differential diagnosis includes influenza, other respiratory viral infections, and community-acquired pneumonia. ICD-10 code [appropriate ICD-10 code, e.g., U07.1 for COVID-19, confirmed] and CPT code [appropriate CPT code, e.g., 87635 for SARS-CoV-2 RNA test] will be used for billing and coding purposes pending test results. Results will be communicated to the patient and appropriate public health reporting will be performed as indicated. Return for evaluation if symptoms worsen or do not improve within [timeframe, e.g., 7-10 days]. Coronavirus testing and screening procedures were followed in accordance with current CDC guidelines.