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COVID-19: Use appropriate diagnoses when billing for COVID testing
October 21, 2020

This article is for providers who bill for COVID-19 testing

It is important to use the appropriate diagnosis code when billing for COVID-19 testing, particularly for differentiating asymptomatic patients from symptomatic patients or patients with suspected exposure to the virus.

If patient is Please use Definition
Asymptomatic and without known COVID-19 contact  
  • Z11.59
  • Encounter for screening for other viral diseases


Symptomatic or has been exposed to COVID-19
  • Z03.818
  • Encounter for observation for suspected exposure to other biological agents ruled out
  • Z20.828
  • Contact with and (suspected) exposure to other viral communicable diseases

Example: The patient presents to the clinic for pre-surgical COVID-19 testing, has no symptoms, and no known contact. In this situation, use code Z11.59.

Questions?

Call Network Management and Credentialing Services at 1-800-316-BLUE (2583).

Resources

 COVID-19 temporary payment policy

MPC_030620-1N-129