By Brenda Ray, CCS, CCS-P, COC, AHIMA-Approved Trainer
Since the beginning of the pandemic, there have been many code changes and updates related to COVID-19 (SARS-CoV-2), with even more for 2021, including new ICD-10-CM diagnosis codes implemented on January 1, 2021. Among these is code Z20.822, contact with and (suspected) exposure to COVID-19, which previously required the code Z20.828. Pay attention to the specific dates around Z20.822 and Z20.828, as this will be critical for billing.
Providers have discovered that most Payors are requiring that a claim be split-billed by year when the claim spans both calendar years, as it relates to Z20.822 and Z20.828. For example, if a patient had pre-op testing done, including a COVID screening (Z20.828), in December of 2020 with a January 2021 outpatient surgery date, likely the claim will be split paid by the year. Please reference specific claim example below:
New ICD-10-CM codes being implemented January 1, 2021 are:
The January 2021 ICD-10-CM Addenda and updated ICD-10-CM Official Guidelines for Coding and Reporting are available at: https://www.cdc.gov/nchs/icd/icd10cm.htm.
This information is provided as an overview of the billing challenge with Z20.822 vs Z20.828. It is intended as informational only, and should not be considered as official payment guidance. Axea Solutions recommends readers inquire directly with payers for appropriate reporting guidelines, as they may vary by payer.