The Zika Virus

Coding Tips,

The Zika virus is a mosquito-borne virus that has been associated with congenital defects, primarily of the central nervous system.  According to the CDC, clinicians should screen women who have traveled to known areas of Zika transmission.  Pregnant women who report clinical illness consistent with the virus should be tested for the virus and should have fetal ultrasound (and possibly amniocentesis) to detect microcephaly or intracranial calcifications.  If they do not report clinical illness consistent with the virus within 2 weeks of travel to an affected region, the CDC recommends that providers consider serial ultrasounds to detect the possible development of microcephaly or other CNS findings. Here are the issues that should be considered when selecting ICD-10-CM diagnosis codes for patients with known or suspected cases of the Zika virus:

ICD-10-CM codes for screening (serology or fetal anatomy ultrasound) due to known or suspected Zika virus exposure

O35.3XX- Maternal care for (suspected) damage to fetus from viral disease in mother (last character designates fetus, if applicable)

Z20.828    Contact with and (suspected) exposure to other viral communicable diseases

If microcephaly or other central nervous system malformation is not identified during the encounter, the provider may choose to instead report Z03.73 Encounter for suspected fetal anomaly ruled out as the primary diagnosis.

ICD-10-CM codes for E/M services for the pregnant woman affected by the Zika virus

O98.51-   Other viral diseases complicating pregnancy (last character designates trimester)

A92.8      Other specified mosquito-borne viral fevers

ICD-10-CM codes for ultrasound services for the pregnant woman affected by the Zika virus

O35.3XX- Maternal care for (suspected) damage to fetus from disease in mother (last character designates fetus, if applicable)

O98.51-   Other viral diseases complicating pregnancy (last character designates trimester)

A92.8          Other specified mosquito-borne viral fevers

ICD-10-CM codes to use once microcephaly or other CNS findings due to the Zika virus are confirmed

O35.3XX-   Maternal care for (suspected) damage to fetus from viral disease in mother (last character designates fetus affected, if applicable), AND/OR

O35.0XX-   Maternal care for (suspected) central nervous system malformation in fetus (last character designates fetus affected, if applicable)

O98.51-    Other viral diseases complicating pregnancy (last character designates trimester)

A92.8        Other specified mosquito-borne viral fevers

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