While none of us will ever forget the COVID- 19 pandemic, we are now five years out from its beginnings. We have noted several coding updates that have arisen along the way. For example, we are now able to assign for long COVID: U09.9 assigns for post-COVID-19 condition, unspecified.
At the beginning of the pandemic, no one knew we would need a code for this condition. According to Centers for Disease Control and Prevention (CDC) data from 2022, about 7.5 percent of adults in the United States have had long COVID.
A 2022 press release noted that this works out to 1 out of every 13 adults. The definition for long COVID CDC used for the data collection was when the patient self-reported the presence of symptoms for at least a three-month period after having COVID-19. These were symptoms they did not have prior to contracting the virus, and this was among those who either had a positive COVID test or a diagnosis of COVID-19 from a doctor.
We can also now assign for under-immunization status for COVID-19. We have codes for both unvaccinated and partially vaccinated status. Prior to this, we had one code option for under-immunization status.
According to USAFacts, as of March 2025, about 81 percent of the U.S. population has received at least one dose of COVID vaccine. About 70 percent of the U.S. population is considered to be fully vaccinated.
Our guidelines for coding COVID have changed as well, as this April 1, there was an update. Official Coding Guideline C.1.g.1.h. has now been revised. This revision addresses how we assign for those asymptomatic individuals who test positive for COVID-19.
Previously, the guidance stated “although the individual is asymptomatic, the individual has tested positive and is considered to have the COVID-19 infection.”
The Guideline revision now states, “for asymptomatic individuals who test positive for COVID-19 (when) there is no provider documentation of a diagnosis of COVID-19, query the provider as to whether or not the individual has COVID-19.” The revision goes on to note that “a false positive laboratory test is possible, and it is the provider’s responsibility to confirm the diagnosis and document accordingly.”
This is a significant change, and means that coders cannot assign COVID based on a positive lab result. There must be physician documentation, or a query is required. Make sure your coding team is aware of this Guideline change, and update your coding policies and procedures on COVID accordingly.
An article in Respiratory Therapy Zone in March asked the question, “Is COVID-19 Making a Comeback in 2025?” The article addressed an increase in transmission rates in several U.S. states. Concern was also raised about possible new surges in the winter/summer months.
The aforementioned article further notes that the World Health Organization (WHO) has shifted from an emergency response to COVID to long-term disease management, indicating an endemic shift. While we would like to forget, COVID-19 is still here. Staying current with our classification and guidelines helps ensure we are reporting as accurately and completely as possible.
A current movement within the clinical revenue cycle is putting utilization review and clinical documentation integrity (CDI) under the same reporting structure. There are many
Last week MedLearn Media published an article by Bryan Nordley titled “Defend Against IR Dialysis Circuit Denials: Expert Coding Tips to Promote Success in 2026.”
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