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Provider Notices

COVID-19 Action Plan and Coding Guidance

3/12/2020 7:56:17 AM

As PacficSource monitors the spread of the coronavirus (COVID-19), our aim is to keep you informed while applying provisions to help curtail the outbreak and optimize access to care. 

Although the severity and impact of the coronavirus outbreak is difficult to predict, we remain in close contact with healthcare providers, state coronavirus response teams, and health agencies in preparation to respond to the needs of members, employees, and providers.

 No member out-of-pocket costs

For the next 60 days per the state-of-emergency declarations, PacificSource is waiving member out-of-pocket costs for COVID-19 testing- and diagnosis-related visits (regardless of the place of service, including telemedicine).  

PacificSource is also covering a one-time early-refill for prescription drugs. 

Coding guidance for COVID-19

The CDC has released Official Coding Guidance for reporting healthcare encounters related to the 2019 novel coronavirus (COVID-19):


ICD-10 Diagnosis Codes

Pneumonia, confirmed as due to COVID-19

J12.89, B97.29

Acute bronchitis, confirmed as due to COVID-19

J20.8, B97.29

Bronchitis NOS, confirmed as due to COVID-19

J40, B97.29

Acute/lower respiratory infection NOS, confirmed as due to COVID-19

J22, B97.29

Respiratory infection NOS, confirmed as due to COVID-19

J98.8, B97.29

Acute respiratory distress syndrome, confirmed as due to COVID-19

J80, B97.29

Possible exposure to COVID-19, condition ruled-out


Exposure to confirmed COVID-19



Coders should follow the Official ICD-10 guidelines for guidance on sequencing, reporting signs and symptoms, and reporting conditions stated as "suspected," "possible," or "probable." 

We recommend providing immediate training to your clinicians regarding proper documentation related to COVID-19. We also recommend providing immediate training to your coders regarding proper ICD-10 assignment for encounters related to COVID-19. 

The complete CDC update is available for download here