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Practice Fusion · Oct 13, 2016

ICD-10 Codes for the ZIKA Virus - Let Your EHR Assist You

Read results from our latest ZIKA Virus Survey about providers perceptions regarding the ZIKA Virus.

Neither ICD-9 nor ICD-10 include specific codes for the Zika virus, making it more difficult than necessary for the WHO, the Centers for Disease Control and Prevention (CDC), and others to track the illness worldwide. The recent spread of Zika virus disease necessitated the need to monitor the disease with a separate code that allows tracking cases of the Zika virus disease. In ICD-9, coders reported code 066.3 (mosquito-borne fever NEC) and in ICD-10, coders report code A92.8 (other specified mosquito-borne viral fevers).

As part of the regular update process, WHO has proposed a new code for the Zika virus, A92.5, Zika virus disease. The adoption of the code will be voted on during the WHO-FIC annual meeting in October 2016. NCHS/CDC is therefore proposing the new code for inclusion in ICD-10-CM, effective October 1, 2016, to be consistent with the planned WHO ICD-10 update. According to the experts at CDC, the science has not been confirmed regarding the relationship between Zika and congenital deformities such as microcephaly. For that reason, an ICD-10-CM code will not be created until the relationship can be scientifically confirmed.

Proposed New Code:
A92.5 Zika virus disease

The ZIKA virus is a flavivirus that causes flu like symptoms in patients. Spread by infected Aedes mosquitoes, the virus poses a big risk to pregnant women and their unborn babies. How would the condition be coded under ICD-10-CM? The most seemingly applicable ICD-10 code would be A92.8 “Other specified mosquito-borne viral fevers”— which includes “Zika (viral)” in its list of fevers . However, not all ZIKA infections result in elevations of body temperature. Besides fever, common ZIKA virus symptoms to code for include maculopapular rash, arthralgia (joint pain), conjunctivitis (pink eye), myalgia (muscular pain) and headache.

For pregnant women who have contracted the virus, 098 is the ICD-10 code for “all maternal infectious and parasitic diseases classifiable elsewhere but complicating pregnancy, childbirth and the puerperium.” Included in this code series is 098.5, “other viral diseases complicating pregnancy, childbirth and the puerperium,” with an additional character to specify the trimester. If the patient has contracted the Guillain-Barré syndrome as a result of the virus, then the ICD-10 diagnosis code would be G61.0.

Infected newborns may develop microcephaly, resulting in unusually small heads and other medical complications. Microcephaly would be coded as Q02, specifying a “congenital abnormality in which the cerebrum is underdeveloped, the fontanels close prematurely, and, as a result, the head is small.”More details about this code can be found in the ICD-10 monitor.

There is a code freeze for any new ICD-10 codes until October 2016 and it is unlikely that the CDC will update the code base for the Zika virus. Thus, while not perfect, the noted ICD-10 codes above are sufficient billable codes. The Practice Fusion EHR has a very intuitive interface to easily find and report on ICD-10 codes. You can sign up and see how you can be charting with new ICD-10 codes in minutes. Don’t worry about memorizing codes — natural language search and refinement filters will help you narrow in on the correct ICD-10 codes quickly.

Update October 2016:

Within the Chapter-Specific Coding Guidelines there are several new additions and revisions. Of particular interest to the ZIKA virus is Chapter 1, Certain Infectious and Parasitic Diseases (A00-B99), where we see “Zika virus infections guidance.” Code only a confirmed diagnosis of Zika virus (A92.5, Zika virus disease) as documented by the provider. In this context, “confirmation” does not require documentation of the type of test performed; the physician’s diagnostic statement that the condition is confirmed is sufficient. This code should be assigned regardless of the stated mode of transmission. If the provider documents “suspected,” “possible,” or “probable” Zika, do not assign code A92.5. Assign a code(s) explaining the reason for encounter (such as fever, rash, or joint pain) or Z20.828, Contact with and (suspected) exposure to other viral communicable diseases.

ZIKA ICD-10 Code Description
A92.5 Zika virus disease, Zika virus fever, Zika virus infection, Zika NOS
098.5 Other viral diseases complicating pregnancy, childbirth and the puerperium
Q02 Congenital abnormality. Includes: hydromicrocephaly and micrencephalon