POSITIVE/CONFIRMED

• Confirmed case (symptomatic, asymptomatic, or presumptive positive) (U07.1)
• Personal history of COVID-19 (Z86.16)
• Follow-up visit, post-COVID (Z09 and Z86.16)

NEGATIVE/UNCONFIRMED

• Exposure to, actual or suspected:
  • asymptomatic (Z20.822)
  • symptomatic, test results inconclusive/unknown (Z20.822)
• Exposure (possible) ruled out (Z03.818)
• Asymptomatic (none or unsure of exposure), ruled out (Z11.59)
• Symptomatic, not confirmed (e.g., rule out, suspected, possible [code symptoms, e.g., R05 Cough])
• Negative COVID-19 but confirmed other condition or illness (report codes for other condition or illness)
• Antibody testing encounter (non confirmatory) (Z01.84)

SCREENING (Do NOT use during pandemic; report exposure code(s) including for preoperative testing)

• Screening asymptomatic individuals (Z11.52)**

MEDICAL CONDITIONS (due to/with COVID): (Sequence U07.1 first ONLY with confirmed cases)

• Acute bronchitis due to COVID-19 (U07.1 and J20.8)
• Acute respiratory distress syndrome (ARDS) (U07.1 and J80)*
• Acute respiratory failure (U07.1 and J96.0-)*
• Lower respiratory infection associated with COVID-19 (J07.1 and [J22 or J98.8, as applicable])
• Multisystem inflammatory syndrome (MIS-C) with (plus other associated complications if applicable):
  • Current COVID infection (U07.1 and M35.81)
  • Previous COVID infection (M35.81 and B94.8)
  • COVID history, but unknown if COVID is the cause (M35.81 and Z86.16)
  • Known/suspected exposure but not current COVID infection or history of (M35.81 and Z20.822)
• Pneumonia due to COVID-19 (U07.1 and J12.82)
• Nonrespiratory manifestations (sequence U07.1 + manifestation codes)
• Other hemolytic-uremic syndrome (U07.1 and D59.39)

IMMUNIZATION STATUS

• Z28.310 "Unvaccinated for COVID-19" may be reported when the patient has not received a COVID-19 vaccine of any type.
• Z28.311 "Partially vaccinated for COVID-19" may be reported when the patient has not completed the required number of vaccinations as recommended by the CDC.

INPATIENT HOSPITAL EXCEPTION

Hospital inpatient only. Code only provider documented or positive test results as U07.1. All "rule out, possible, probable, suspected, or inconclusive" results should be reported as symptoms NOT code U07.1.

• COVID infection
  • Progressing to sepsis (see Section I.C.1.d. guidelines); In pregnancy (see Section 1.c.15.s); In newborn (see Section I.C.16.h); In lung transplant patient (see Section I.C.19.g.3.a.)

Post-COVID Condition