The Centers for Medicare & Medicaid Services has assigned Medicare Severity-Diagnosis-Related Groups to six new ICD-10 diagnosis codes for reporting conditions related to COVID-19 on medical claims effective Jan. 1. The codes are for pneumonia due to COVID-19; multisystem inflammatory syndrome; other systemic involvement of connective tissue; COVID-19 screening; suspected exposure to COVID-19; and personal history of COVID-19. CMS also is implementing 21 new ICD-10 procedure codes for COVID-19 vaccines and therapeutics, including monoclonal antibodies. For details, see the latest news on the CMS MS-DRG webpage.

CMS notes that for hospitalized patients, Medicare pays for COVID-19 vaccines and their administration separately from the Diagnosis-Related Group rate. “As such Medicare expects that the appropriate [Current Procedural Terminology] codes will be used when a Medicare beneficiary is administered a vaccine while a hospital inpatient,” the guidance notes. For details on billing Medicare for COVID-19 vaccines appropriately, see the CMS provider toolkit.

Related News Articles

Headline
The Occupational Safety and Health Administration today announced a 60-day extension of the comment period on its proposed rule to remove the remaining…
Headline
COVID-19 infections are growing or likely growing in 45 states and not changing in five states, according to the latest data from the Centers for Disease…
Headline
The Food and Drug Administration July 15 announced a recall by Sandoz on certain lots of cefazolin, due to the lots being mislabeled as penicillin G potassium…
Headline
 The Food and Drug Administration July 10 approved Moderna’s Spikevax COVID-19 vaccine for children under 12 with at least one underlying condition that…
Headline
The Occupational Safety and Health Administration June 30 released a proposed rule to remove what remains of its emergency temporary standard for occupational…
Headline
Department of Health and Human Services Secretary Robert F. Kennedy Jr. May 27 announced in a post on X that the Centers for Disease Control and Prevention…