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 public health emergency will likely remain in place through 2021, and the administration will give states 60 days’ notice before it decides to terminate…
Headline
The Food and Drug Administration Jan. 21 reissued emergency use authorizations for 10 systems authorized to decontaminate certain N95 respirators used by…
Headline
Pfizer Inc. has completed enrolling children aged 12 to 15 in a COVID-19 vaccine study, the drug maker confirmed Friday.  Pfizer said the Phase 3…
Chairperson's File
This year, I look forward to continuing AHA’s Leadership Rounds, short conversations on trending topics with health care leaders from around the country.…
Headline
As COVID-19 surges continue, lessons learned by health systems large and small reveal the importance of teamwork, communication, flexibility, preparation and…
Headline
The Centers for Disease Control and Prevention today reported 10 cases of anaphylaxis, a life-threatening allergic reaction, among the more than 4 million…