Cracking the Code
Coding COVID-19 Patient Lung Transplant Status
When a patient is admitted for management of respiratory manifestations of COVID-19 and is also status-post lung transplant, the coding guidelines state that lung transplant infection diagnosis should be sequenced as the primary diagnosis followed by U07.1, COVID-19 as a secondary diagnosis. It is VERY important to pay attention to the sequencing of the diagnoses. The Tabular List note at the lung transplant infection code states to “use additional code to specify infection”, and coding guidelines state “a transplant complication code is only assigned if the complication affects the function of the transplanted organ.” In this scenario, the COVID-19 infection has affected the function of the transplanted lung.
Q: Patient presents to the ED with cough and shortness of breath. The patient has history of lung cancer and lung transplantation. The physician orders a lab to test for COVID-19, and the results are positive for the virus.
A: T86.812, lung transplant infection U07.1, COVID-19
Reference: ICD-10-CM Official Guidelines for Coding and Reporting FY 2020, Section I.C.19.g.3.a.