Follow This Advice when You Dx Zika Virus Patients

Posted on 10 Feb, 2016 |comments_icon 1|By Chris Boucher

Pregnant women get different ICD-10s than other Zika patients.

News headlines have been swirling around the Zika virus for days now, and it looks like the virus could become an epidemic in the Americas, if not properly contained.

This will cause concern in the general population, of course, but as a coder you need to be ready in the unlikely event that a Zika virus patient walks through your door. 

Do this: Follow this guide to diagnosis codes for the Zika virus, in the unfortunate even that it spreads on your community. 

Use ‘Mosquito-Borne’ ICD-10 for Nonpregnant Patients

“There isn’t an actual code for this particular virus — yet,” says Leslie Johnson, CPC, CSFAC, chief coding officer at PRN Advisors in Palm Coast, Fla.,

“Since it’s a mosquito-borne virus, however, you should probably use A92.8 (Other specified mosquito-borne viral fevers),” Johnson recommends.

The A92.8 code is probably the best option for nonpregnant patients, agrees Catherine Brink, BS, CPC, CMM, CPOM, CMSCS, president of Healthcare Resource Management, Inc. in Spring Lake, N.J.

Best bet: “Since there is not a specific ICD-10 code for Zika virus, a provider may want to contact the insurance carrier” before choosing an ICD-10 code, Brink recommends. 

Look to ‘O’ Category for Pregnant Patients

You won’t want to use the same diagnosis codes for pregnant women, however. As the disease can definitely affect the pregnancy — and the fetus — your best choice is probably O98.51 (Other viral diseases complicating pregnancy), Johnson says.

Again, you should check with your payer before submitting any codes for pregnant patients with Zika virus. While there might be some expert consensus on what the best ICD-10 code might be, you won’t know for sure until you get confirmation from each payer. 

Also: Keep your ear to the ground for official guidance on the Zika virus. If a payer issues any info on Zika virus coding, you’ll want to get it as soon as possible.


Chris Boucher

Chris Boucher has nearly 10 years of experience writing various newsletters and other products for The Coding Institute. His blog will cover several areas of coding and compliance, including CPT® coding, modifiers, HIPAA compliance and ICD-10 coding.

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