How to Bill and Code COVID Toes

So Coronavirus or COVID 19 appears to cause the formation of the lower extremity as something called COVID toes. Here is an article with a fairly decent description of the COVID toes appearance.

https://apnews.com/6dcacfca0f7e1bd9f9ca5e5b98c4296b

Now be forewarned there is no settled definition of what COVID toes are and there is some disagreement they are just another rash of some kind. Due to this disagreement the diagnosis and coding of COVID toes can be difficult. The other aspect is no procedures are currently being done for COVID toes (cause if COVID toes are legit the patient has bigger worries). So if you are diagnosing COVID toes in a patient you would thus go to the traditional E and M level. Needless to say the instinct will be to bill at a high E and M level for if you are making the COVID toes diagnosis you are most likely doing a very detailed history with it.

Now for ICD 10 coding of COVID toes you have 2 codes to choose from:

U07.1 can be used but only if you have a positive COVID test diagnosis. If there is no positive test you cannot use that code

If there is not then use the code:

Z20.828 Contact with suspected exposure of a viral communicable disease

Here is the actual CDC guidelines

https://www.cdc.gov/nchs/data/icd/COVID-19-guidelines-final.pdf

My person opinion is that you probably should not mess with COVID Toes diagnosis and just use regular dermatology codes that cover COVID toes.

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