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COVID-19 Treatment

Back to COVID-19 Provider Update Center

The coding information on this page applies to healthcare providers and labs.

Blue Cross and Blue Shield Plans nationwide are implementing various types of cost-sharing waivers related to the COVID-19 Public Health Emergency. There could be variations in cost-sharing for telehealth and other services for some patients who have employer-based coverage or coverage under another Blue Cross and Blue Shield Plan outside of Alabama.

  • Always check eligibility and benefits through ProviderAccess or your practice management system to confirm coverage and cost-sharing details for each patient.
  • Refer to our Telehealth page for detailed information about eligible telehealth services.
  • For guidance on procedure codes related to testing and specimen collection, see our COVID-19 Testing page.
  • View our FEP Coverage and Billing Information page for information about COVID-19 and telehealth coverage, billing and cost-sharing (deductibles, copayments, etc.) for Blue Cross and Blue Shield Federal Employee Program® (BCBS FEP) members.

Diagnosis Codes

In March, the CDC announced a new ICD-10 emergency code was established by the World Health Organization. This code, U07.1, should be used for confirmed COVID-19 cases only, for dates of service beginning April 1, 2020.

Code Description Comment
U07.1 2019-nCoV acute respiratory disease This code should be used for confirmed COVID-19 cases only, for dates of service beginning April 1, 2020.
B97.29

Other coronavirus as the cause of diseases classified elsewhere

Instruction is to bill this code for confirmed cases of COVID-19, in addition to the code for the presenting illness.

If the provider documents “suspected,” “possible” or “probable” COVID-19, do not assign code B97.29. Assign a code(s) explaining the reason for encounter (such as fever and Z20.828).

Z03.818 Encounter for observation for suspected exposure to other biological agents ruled out. Use if a there is a concern that a patient has had a possible exposure to COVID-19, but this is ruled out after evaluation.
Z20.828 Contact with and (suspected) exposure to other viral communicable diseases. Use if a patient has been exposed to someone with a documented case of any form of the virus including COVID-19.
B34.2 Coronavirus infection, unspecified This code is not generally appropriate for COVID-19 because confirmed cases have universally been respiratory in nature, so the site would not be unspecified.

Reference: https://www.cdc.gov/nchs/data/icd/ICD-10-CM-Official-Coding-Gudance-Interim-Advice-coronavirus-feb-20-2020.pdf

Confirmed Cases

Per the CDC, to identify patients who have tested positive for COVID-19, current CDC guidance instructs to code first for the presenting illness followed by "B97.29 - Other coronavirus as the cause of diseases classified elsewhere." 

For confirmed cases of pneumonia due to COVID-19:

  • J12.89, Other viral pneumonia, and
  • B97.29, Other coronavirus as the cause of diseases classified elsewhere

For confirmed cases of acute bronchitis due to COVID-19:

  • J20.8, Acute bronchitis due to other specified organisms, and
  • B97.29, Other coronavirus as the cause of diseases classified elsewhere

For bronchitis not otherwise specified (NOS) due to COVID-19:

  • J40, Bronchitis, not specified as acute or chronic, along with code
  • B97.29, other coronavirus as the cause of diseases classified elsewhere

For lower respiratory infections, NOS, or an acute respiratory infection, NOS, with associated documented COVID-19:

  • J22, Unspecified acute lower respiratory infection, with code
  • B97.29, Other coronavirus as the cause of diseases classified elsewhere

For respiratory infections, NOS, with associated documented COVID-19:

  • J98.8, Other specified respiratory disorders, with
  • B97.29, Other coronavirus as the cause of diseases classified elsewhere

For confirmed acute respiratory distress syndrome (ARDS) due to COVID-19:

  • J80, Acute respiratory distress syndrome, and
  • B97.29, Other coronavirus as the cause of diseases classified elsewhere

Unconfirmed Cases

To code a concern about COVID-19 exposure that was ruled out after evaluation:

  • Z03.818, Encounter for observation for suspected exposure to other biological agents ruled out

To code actual COVID-19 exposure to a confirmed coronavirus case:

  • Z20.828, Contact with and (suspected) exposure to other viral communicable diseases

For patients presenting with symptoms where a definitive coronavirus diagnosis is not established, assign the appropriate codes for each presenting symptom, such as:

  • R05, Cough
  • R06.02, Shortness of breath
  • R50.9, Fever, unspecified

Prescription Medication Updates

FDA Revokes Emergency Use Authorization for Hydroxychloroquine and Chloroquine

The U.S. Food and Drug Administration (FDA) in a June 15, 2020, statement revoked the emergency use authorization (EUA) for hydroxychloroquine sulfate and chloroquine phosphate to treat certain hospitalized patients with COVID-19.

“Based on its ongoing analysis of the EUA and emerging scientific data, the FDA determined that chloroquine and hydroxychloroquine are unlikely to be effective in treating COVID-19 for the authorized uses in the EUA. Additionally, in light of ongoing serious cardiac adverse events and other potential serious side effects, the known and potential benefits of chloroquine and hydroxychloroquine no longer outweigh the known and potential risks for the authorized use,” the FDA said in the statement.

Additional resources about use of these medications for COVID-19:

Dispensing Limits on Hydroxychloroquine, Chloroquine and Azithromycin

Blue Cross is discontinuing the dispensing limits on these drugs as of August 1, 2020:

  • Effective April 2, 2020, Blue Cross placed a dispensing limit, or quantity limit, on new prescriptions of hydroxychloroquine and chloroquine.
  • Effective April 7, 2020, Blue Cross placed a dispensing limit on new prescriptions for azithromycin. This will include a cumulative limit of 60 tablets per 180 days for all dosage strengths.

Early-Refill Restrictions Lifted

  • We are working with Prime Therapeutics® to allow our members to obtain early refills of their medications.
  • Diabetic supplies filled under the patient's prescription benefits are subject to the same early-refill allowance as other prescription medications.

Other Impacted Programs and Services

DME Update for Oxygen Therapy

In response to the ongoing COVID-19 Public Health Emergency, we are resuming suspension of the oxygen saturation requirement for both certification and recertification. This action is effective March 1, 2020, and expires on December 1, 2020. We will re-evaluate for a continuance as needed.

For information about coverage of oxygen therapy, please refer to our medical policy MP-317 on AlabamaBlue.com/providers/policies.

Coronavirus Codes Added to List of Services Carved Out of EAPG Pricing

The Services Carved Out of EAPG Pricing document has been updated with three coronavirus HCPCS codes and their corresponding fees.

Blue Advantage® Home Health Services Update

Blue Cross is following CMS’ home health modifications that allow nurse practitioners, clinical nurse specialists or physician assistants to perform the following for Blue Advantage patients:

  • Order home health services.
  • Establish and periodically review a plan of care for home health services (e.g., sign the plan of care).
  • Certify and recertify that the patient is eligible for Medicare home health services.

This update is included in the online document Home Health Agencies: CMS Flexibilities to Fight COVID-19.

Attention Dentists: Blue Cross Not Allowing PPE Charges

Blue Cross and Blue Shield of Alabama is not reimbursing for CDT code D1999 (unspecified preventive procedure, by report) when used to document and report the use and cost of additional personal protective equipment (PPE).

Our global allowance for the major procedure includes the cost of PPE. As a result, PPE is not billable either separately or to the patient. Code D1999 will be rejected if submitted on a claim. Additionally, if Blue Cross patients have paid additional fees for PPE, we expect providers to refund the amount charged to them.