New condition code released for COVID-19 claims
By Morgan Haefner, Becker’s Hospital Review
April 7, 2020
The National Uniform Billing Committee released a new condition code for claims related to COVID-19.
In a March 23 announcement, NUBC said without codes that specifically indicate COVID-19, including service for cases when a patient ultimately tests negative, payers will struggle to know which claims should be handled differently.
NUBC recommended the following to ensure claims for COVID-19-related care are flagged appropriately:
- Use the “DR” condition code, which identifies claims that are or could be affected by policies related to a national or regional disaster.
- Use one of the following diagnosis codes:
- 29 (other coronavirus as the cause of diseases classified elsewhere) for services provided before April 1
- 1 (COVID-19) for services provided on or after April 1
- 818 (Encounter for observation for suspected exposure to other biological agents ruled out)
- 828 (Contact with and suspected exposure to other viral communicable diseases)
Read the full guidance here.