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In the midst of the ongoing COVID-19 pandemic, the Centers for Medicare and Medicaid Services (CMS) has taken significant steps to protect the health and safety of patients and healthcare providers. One such initiative is the release of new codes for COVID-19 immunization status. These codes enable accurate reporting and tracking of vaccination status, as well as the identification of long-term effects of COVID-19 infections. In this blog post, we will delve into the details of these new codes and discuss their importance in healthcare management.
New Codes for COVID-19 Immunization Status:
CMS, in collaboration with the Center for Disease Control and Prevention (CDC), has introduced three new diagnosis codes for reporting COVID-19 vaccination status. These codes will go into effect on April 1st, 2022. Here are the new codes:
- Z28.310 – Unvaccinated for COVID-19
- Z28.311 – Partially vaccinated for COVID-19
- Z28.39 – Other under immunization status
These codes aim to provide more specific information regarding the vaccination status of individuals. They will be crucial for tracking purposes, allowing healthcare organizations to monitor the progress of immunization efforts and identify gaps in vaccination coverage.
Update Frequency of ICD-10-CM:
It is important to note that CMS and the National Center for Health Statistics (NCHS) have made changes to the update frequency of the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM). Prior to 2021, updates were typically released on October 1st. However, from 2021 onwards, updates will occur twice a year – on October 1st and April 1st. This change aims to ensure more timely inclusion of new diagnosis codes, including those related to emerging diseases and often-changing treatment protocols.
Role of the ICD-10-CM Codebook:
The ICD-10-CM codebook is an essential resource for healthcare professionals involved in coding and billing. For accurate reporting of COVID-19 immunization status, familiarity with the outpatient diagnosis coding guidelines and the dedicated section for COVID-19 diagnoses in the codebook is crucial. The guidelines provide instructions on code selection, reporting scenarios, and proper placement of codes on claim forms for appropriate payment and reimbursement.
Steps to Assigning Appropriate Diagnosis Codes:
When assigning diagnosis codes for COVID-19 evaluation and tracking expenses, it is important to follow a systematic approach. Here are some steps healthcare professionals can take:
- Familiarize Yourself with Outpatient Diagnosis Coding Guidelines: The first step is to become familiar with the outpatient diagnosis coding guidelines mentioned in the codebook. These guidelines provide valuable information on reporting COVID-19 diagnoses and their placement on claim forms.
- Create Reference Sheets: Developing reference sheets with the most commonly used ICD-10 codes, including those related to COVID-19, will ensure accurate code selection. Including the new codes for COVID-19 immunization status on these sheets will help streamline coding processes.
- Establish Documentation Templates: Providers should use documentation templates that support code selection. These templates should capture relevant patient information, such as chief complaints, symptoms, exposure history, and other pertinent details. Complete and consistent documentation is essential for accurate coding and reporting.
- Track Expenses Appropriately: Monitoring claim denials, appealing denials when necessary, and ensuring appropriate tracking of expenses associated with COVID-19 evaluation and management is crucial for efficient revenue cycle management.
The release of new codes for COVID-19 immunization status by CMS marks an important milestone in healthcare management during the pandemic. These codes allow for accurate reporting and tracking of vaccination status, ensuring timely identification and response to gaps in immunization coverage. Healthcare professionals must stay updated and familiarize themselves with the outpatient diagnosis coding guidelines and the dedicated section for COVID-19 diagnoses in the ICD-10-CM codebook. By following the recommended steps for assigning appropriate diagnosis codes and tracking expenses, healthcare organizations can effectively manage COVID-19 cases and optimize their revenue cycle processes.
Additional Resources
ACOEM coding tip sheet workers compensation – Via Google Drive
ACOEM coding tip sheet workers compensation – Via Dropbox
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