AHA Coding Clinic on ICD-10-CM/PCS for First Quarter of 2021 Released

Current issue includes most frequently asked questions about coding COVID-19.

The American Hospital Association (AHA) central office is the official United States clearinghouse on medical coding for the proper use of the ICD-10-CM/PCS systems and Level I HCPCS (CPT-4 codes) for hospital providers – and certain Level II HCPCS codes for hospitals, physicians, and other health professionals.

The Coding Clinic on ICD-10-CM/PCS is a particular publication that is a terrific coding resource and reference that is a must-have and must-read for all health information management (HIM), coding, and clinical documentation improvement (CDI) professionals.

The AHA Coding Clinic on ICD-10-CM/PCS for the first quarter was released last month (March 20, 2021), and included in the issue are the most recent COVID-19 coding frequently asked questions (FAQs), along with the Jan. 1, 2021 updated Official Guidelines for Coding and Reporting, focusing on COVID-19 coding (visit:  https://www.cdc.gov/nchs/data/icd/ICD-10cmguidelines-FY2021- COVID-update-January-2021-508.pdf). In addition,  the usual section for “Ask the Editor” coding questions with answers or guidance is included in the issue, a segment that always offers some interesting coding situations and responses.

I want to mention that the FAQ on COVID-19 coding is a collaboration with the American Health Information Management Association (AHIMA) and AHA. Since the public health emergency (PHE) started, there have been regular updates to COVID-19 coding via the FAQ, so keeping up to date is needed and required. It might be best to check either AHA or AHIMA every one or two weeks for any new or revised COVID-19 coding guidance. The most recent FAQ update was on March 1, 2021. I appreciate the questions and answers being addressed, like question No. 52:
 

Question: How is an encounter/admission for COVID-associated pneumonia coded when the patient’s latest COVID-19 test result is negative?

Answer: Assign code U07.1. COVID-19 (is) the principal or first-listed diagnosis, because the pneumonia is an acute manifestation of the COVID-19 infection. Assign code J12.82, Pneumonia due to coronavirus disease 2019, as an additional diagnosis. The instructional note under code U07.1 directs to use an additional code to identify pneumonia or other manifestations. Therefore, when a patient presents with an acute manifestation of COVID-19, such as pneumonia, code U07.1 should be reported as the principal or first diagnosis, regardless of whether the patient’s most recent COVID-19 test is positive or negative.

Now, remember that there are some new codes starting Jan. 1, 2021, so the COVID-19 FAQ builds off of that. New ICD-10-CM codes that were implemented Jan. 1, 2021 are:

• 82, Pneumonia due to coronavirus disease 2019
• 81, Multisystem inflammatory syndrome
• 822, Contact with and (suspected) exposure to COVID-19
• 16, Personal history of COVID-19

There were also some ICD-10-PCS new codes released for use, starting Jan. 1, 2021.

Under the “Ask of Editor” section of Coding Clinic, there are questions regarding the ICD-10-CM codes for Pseudoseizure (Dx) – R56.9, Pseudoseizure unspecified; Multiple Sclerosis and Peripheral Neuropathy (Dx) – G35, Multiple Sclerosis, and G63 Polyneuropathy; and the coding of Chronic Hepatic Failure with Toxic Metabolic Encephalopathy due to Acute on Chronic Hepatic Encephalopathy (Dx) – K72.10, Chronic Hepatic Failure, and G92 Toxic Metabolic Encephalopathy, just to mention a few.

There is also guidance on the PCS coding that includes but is not limited to:

• The Placement of a Spacer for Decompression (PCS), Table 0SH;
• The Placement of a “Sentinel” Embolic Protection Device (PCS), Table 03J; and
• The Total Proctocolectomy with J-Pouch Creation (PCS), Table 0DU

The AHA Coding Clinic on ICD-10-CM/PCS can be accessed at the AHA website. So be sure to check that out, as a paid subscription is required, but definitely worth the fee. You can, however, submit ICD-10-CM and PCS coding questions for free via the online portal, so that is also a great option for coding and even CDI professionals (https://www.codingclinicadvisor.com/ Home/HelpCenter).

The AHA Coding Clinic is not just for hospital coding; their guidance often applies to all the different healthcare settings, even physician offices and clinics.

With this new release of Coding Clinic, there are some steps that I advise HIM, coding, and CDI professionals to take:

• Conduct and complete a read of the issue within the next 20-30 days;
• Discuss with all coding and CDI staff (enjoy the process);
• If there are questions, discuss them; if some questions remain, submit them to AHA Coding Clinic online;
• Schedule a weekly check of the AHA/AHIMA website on FAQ on COVID-19 coding;
• Schedule a coding audit within the next 50-60 days on encounters from the first quarter of 2021 (internal and/or external audit);
• Educate and reaudit; and
• Time for the next edition of Coding Clinic!

ICD10monitor and Medlearn Media have released an on-demand webcast dedicated to the new issue, so you can register for that if you are inclined to learn more. The AHA Coding Clinic publication is an excellent learning tool, so embrace it and gain new knowledge.