Medicare enables COVID-19 ICD-10 code for Section 111 reporting

April 9, 2020 / 1 min read

As the COVID-19 pandemic continues, questions are surfacing regarding associated coding for the illness for Section 111 reporting activities.

On this point, the Centers for Disease Control and Prevention (CDC) issued a bulletin advising it is implementing the new ICD-10 U07.1 for “COVID-19, virus identified” in an off-cycle update effective April 1, 2020, to code the COVID-19 diagnosis. This coding update was originally scheduled to become effective on October 1, 2020, but, as noted, has now been accelerated for usage effective April 1, 2020.

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In terms of Section 111 reporting, since U07.1 was newly adopted by the CDC, it wasn’t initially included in the list of accepted Section 111 codes and was not immediately available for use. Medicare needed to first add the code into its system before it could be accepted. While CMS has not issued a formal updated Section 111 Alert, we have learned that the Benefits Coordination and Recovery Center (BCRC) has recently added U07.1 to the list of accepted codes for all insurance types under Section 111 reporting and that Responsible Reporting Entities (RREs) can now use it for Section 111 reporting requirements. Of note, only U07.1 is currently accepted for reporting, and the U07.2 code “COVID-19, virus not identified” has not been added to the Section 111 list of accepted codes.

We will continue to provide subsequent updates as warranted. In the interim, please do not hesitate to contact me if you have any questions.