As the country reopens, we continue to help brokers serve their clients. This update is intended for individuals that test for COVID-19 and employers that require precautionary employee testing. Find all of our billing and coding updates here: https://www.billdog.com/blog
COVID-19 primary diagnosis code
COVID-19 hospital costs average $23,500 and can be two or three times that for patients with complications. Less understood are the long-term effects of COVID-19. Preliminary studies indicate COVID-19 may cause long-term heart, lung, and kidney damage, even for mild cases.
Some insurers may waive fees for post-viral health problems and federal funds may be available to cover additional costs (like out-of-network charges) -- as long as these complications are linked to COVID-19 on their medical bill.
For an employee that receives a positive COVID-19 diagnosis, see that it is coded U07.1. The code applies regardless of the type of test administered.
For a confirmed positive COVID-19 diagnosis with a complication, see that it is first coded with U07.1, followed by the complication code. Eg. COVID-19 plus acute bronchitis is coded U07.1, J20.8.
(Codes for NEGATIVE results, for tests administered to individuals with no symptoms, eg. routine screening or pre-elective-procedures tests see codes Z11.59, Z03.818 or Z03.828)
Precautionary COVID Testing for Employees
Insurance companies will cover testing, so long as it’s “medically necessary”. A doctor can order testing only when an individual is exhibiting symptoms of the illness. Employers that are pressed to provide precautionary testing for employees may want to consider one of these strategies:
• Contract for test-at-work service (See Wellness Coaches - wellnesscoachesusa.com)
• Wearables that may indicate COVID before symptoms show up (See PGA tour using Whoop)
• AI platforms, some which protect privacy (See jvion.com)
• Pooled testing alternatives. With individual tests costs of $100+, employee pooled-testing services may provide a significantly lower-cost alternative for employers. (See https://healthpolicy.usc.edu/article/a-testing-strategy-to-get-americans-back-to-work-and-school/)
If you have any question or need help with any billing or claims issue, please feel free to get assistance here: https://www.billdog.com/get-started-secure-submit