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ICD-10 Coding for Personal History of COVID-19(Z86.16, U07.1, U09.9)

Complete ICD-10-CM coding and documentation guide for Personal History of COVID-19. Includes clinical validation requirements, documentation requirements, and coding pitfalls.

Also known as:

Resolved COVID-19Past COVID-19 Infection

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Related ICD-10 Code Ranges

Complete code families applicable to Personal History of COVID-19

Z86.1-Z86.19Primary Range

Personal history of infectious and parasitic diseases

This range includes codes for personal history of resolved infectious diseases, including COVID-19.

U07.1

COVID-19, virus identified

Used for active COVID-19 infections confirmed by laboratory testing.

U09.9

Post COVID-19 condition, unspecified

Used for conditions that are sequelae of a previous COVID-19 infection.

Code Comparison: When to Use Each Code

Compare key differences between these codes to ensure accurate selection

CodeDescriptionWhen to UseKey Documentation
Z86.16Personal history of COVID-19Use when the patient has a documented history of COVID-19 that is resolved and not currently being treated.
  • Provider documentation stating COVID-19 is resolved
  • Negative PCR or antigen test
  • Absence of symptoms
U07.1COVID-19, virus identifiedUse for confirmed active COVID-19 infections.
  • Positive PCR or antigen test
  • Presence of symptoms
U09.9Post COVID-19 condition, unspecifiedUse for conditions resulting from a past COVID-19 infection.
  • Documented sequelae related to past COVID-19 infection

Clinical Decision Support

Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.

Key Information: ICD-10 code for personal history of COVID-19

Essential facts and insights about Personal History of COVID-19

The ICD-10 code for personal history of COVID-19 is Z86.16, used when the infection is resolved.

Primary ICD-10-CM Codes for personal history of covid

Z86.16
Personal history of COVID-19
Billable Code

Decision Criteria

clinical Criteria

  • Patient has no current symptoms and a negative test result.

documentation Criteria

  • Provider notes indicate COVID-19 is resolved.

Applicable To

  • Resolved COVID-19 infection

Excludes

  • Active COVID-19 infection (U07.1)
  • Post-COVID conditions (U09.9)

Clinical Validation Requirements

  • Provider documentation stating COVID-19 is resolved
  • Negative PCR or antigen test
  • Absence of symptoms

Code-Specific Risks

  • Incorrectly using for active COVID-19 cases
  • Confusing with post-COVID conditions

Coding Notes

  • Ensure documentation clearly states COVID-19 is resolved to use Z86.16.
View Full Code Details

Ancillary Codes

Additional codes that should be used in conjunction with the main diagnosis codes when applicable.

Follow-up examination after treatment for conditions other than malignant neoplasm

Z09
Use for follow-up visits after COVID-19 recovery.

Differential Codes

Alternative codes to consider when ruling out similar conditions to the primary diagnosis.

Post COVID-19 condition, unspecified

U09.9
Use U09.9 for sequelae or lingering symptoms post-COVID-19, not Z86.16.

Documentation & Coding Risks

Avoid these common documentation and coding issues when documenting Personal History of COVID-19 to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code Z86.16.

Impact

Clinical: Inaccurate patient history, Regulatory: Non-compliance with coding standards, Financial: Potential claim denials

Mitigation Strategy

Ensure detailed documentation of resolution, Confirm absence of symptoms

Impact

Reimbursement: Incorrect coding can lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate patient records.

Mitigation Strategy

Use U07.1 for active infections.

Impact

Reimbursement: Potential for incorrect DRG assignment., Compliance: Misrepresentation of patient condition., Data Quality: Misleading health data.

Mitigation Strategy

Use U09.9 for sequelae, not Z86.16.

Impact

Using Z86.16 for active or post-COVID conditions.

Mitigation Strategy

Ensure documentation supports resolved status.

Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.

Frequently Asked Questions

Common questions about ICD-10 coding for Personal History of COVID-19, with expert answers to help guide accurate code selection and documentation.

Documentation Templates for Personal History of COVID-19

Use these documentation templates to ensure complete and accurate documentation for Personal History of COVID-19. These templates include all required elements for proper coding and billing.

Routine follow-up after COVID-19 recovery

Specialty: Primary Care

Required Elements

  • Patient history
  • Resolution of symptoms
  • Negative test results

Example Documentation

Patient presents for routine follow-up. COVID-19 resolved as of 02/2025. No current symptoms.

Examples: Poor vs. Good Documentation

Poor Documentation Example
Patient had COVID last year.
Good Documentation Example
Patient had COVID-19, resolved as of 02/2025, no current symptoms.
Explanation
The good example provides specific resolution details and confirms absence of symptoms.

Need help with ICD-10 coding for Personal History of COVID-19? Ask your questions below.

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