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KMAP BULLETIN: UPDATED New COVID ICD-10 Diagnosis Codes and PCS Procedure Codes Effective January 1, 2021

Date: 02/10/21

KMAP GENERAL BULLETIN 21011 (PDF)

Effective with dates of service January 1, 2021, newly created International Classification of Diseases (ICD)-10-Clinical Modification (CM) diagnosis codes and ICD-10 Procedural Classification System (PCS) related to COVID-19 will be covered. These new codes will identify conditions resulting from COVID-19. Claims will continue to be exempt from copay when using the Centers for Medicare and Medicaid Services (CMS) approved coding guidelines and diagnosis combinations.

ICD-10 Diagnosis Codes:

  • Z11.52 - Encounter for screening for COVID-19
  • Z20.822 - Contact with and suspected exposure to COVID-19
  • Z86.16 - Personal history of COVID-19
  • M35.81 - Multisystem inflammatory syndrome
  • M35.89 - Other specified systemic involvement of connective tissue
  • J12.82 - Pneumonia due to coronavirus disease 2019

ICD-10 PCS Procedure Codes:

  • XW013H6 - Introduction of Other New Technology Monoclonal Antibody into Subcutaneous Tissue, Percutaneous Approach, New Technology Group 6
  • XW013K6 - Introduction of Leronlimab Monoclonal Antibody into Subcutaneous Tissue, Percutaneous Approach, New Technology Group 6
  • XW013S6 - Introduction of COVID-19 Vaccine Dose 1 into Subcutaneous Tissue, Percutaneous Approach, New Technology Group 6
  • XW013T6 - Introduction of COVID-19 Vaccine Dose 2 into Subcutaneous Tissue, Percutaneous Approach, New Technology Group 6
  • XW013U6 - Introduction of COVID-19 Vaccine into Subcutaneous Tissue, Percutaneous Approach, New Technology Group 6
  • XW023S6 - Introduction of COVID-19 Vaccine Dose 1 into Muscle, Percutaneous Approach, New Technology Group 6
  • XW023T6 - Introduction of COVID-19 Vaccine Dose 2 into Muscle, Percutaneous Approach, New Technology Group 6
  • XW023U6 - Introduction of COVID-19 Vaccine into Muscle, Percutaneous Approach, New Technology Group 6
  • XW033E6 - Introduction of Etesevimab Monoclonal Antibody into Peripheral Vein, Percutaneous Approach, New Technology Group 6
  • XW033F6 - Introduction of Bamlanivimab Monoclonal Antibody into Peripheral Vein, Percutaneous Approach, New Technology Group 6
  • XW033G6 - Introduction of REGN-COV2 Monoclonal Antibody into Peripheral Vein, Percutaneous Approach, New Technology Group 6
  • XW033H6 - Introduction of Other New Technology Monoclonal Antibody into Peripheral Vein, Percutaneous Approach, New Technology Group 6
  • XW033L6 - Introduction of CD24Fc Immunomodulator into Peripheral Vein, Percutaneous Approach, New Technology Group 6
  • XW043E6 - Introduction of Etesevimab Monoclonal Antibody into Central Vein, Percutaneous Approach, New Technology Group 6
  • XW043F6 - Introduction of Bamlanivimab Monoclonal Antibody into Central Vein, Percutaneous Approach, New Technology Group 6
  • XW043G6 - Introduction of REGN-COV2 Monoclonal Antibody into Central Vein, Percutaneous Approach, New Technology Group 6
  • XW043H6 - Introduction of Other New Technology Monoclonal Antibody into Central Vein, Percutaneous Approach, New Technology Group 6
  • XW043L6 - Introduction of CD24Fc Immunomodulator into Central Vein, Percutaneous Approach, New Technology Group 6
  • XW0DXM6 - Introduction of Baricitinib into Mouth and Pharynx, External Approach, New Technology Group 6
  • XW0G7M6 - Introduction of Baricitinib into Upper GI, Via Natural or Artificial Opening, New Technology Group 6
  • XW0H7M6 - Introduction of Baricitinib into Lower GI, Via Natural or Artificial Opening, New Technology Group 6

Kansas Medicaid issued guidance for billing testing and treatment of COVID-19 in General Bulletin 20041 (PDF).

Note: The effective date of the policy is January 1, 2021. The implementation of State policy by the KanCare Managed Care Organizations (MCOs) may vary from the date noted in the Kansas Medical Assistance Program (KMAP) bulletins. The KanCare Open Claims Resolution Log on the KMAP Bulletins page documents the MCO system status for policy implementation and any associated reprocessing completion dates, once the policy is implemented.