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U07.1 ICD-10-CM Code: COVID-19

Compare with another code for U07.1Check this code on a claim

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Coding at a Glance

Official instructions
2 Excludes2 · 7 use-additional instructions

What these terms mean →

Billable · FY2027A valid, specific ICD-10-CM code, reportable for dates of service in FY2027.

What you need to know

Source: CMS/NCHS Official ICD-10-CM tabular notes, quoted. From the CMS/NCHS tabular list for the release in force. A note the category or block publishes applies to this code too, and is marked with where it comes from.

Use additional codeReport with this code when documented
  • Use additional code to identify pneumonia or other manifestations, such as:
  • pneumonia due to COVID-19 (J12.82)
  • Use additional code, if applicable, for associated conditions such as:
  • COVID-19 associated coagulopathy (D68.8)

+3 more in Instructions

Excludes2Not included here; may be reported together
  • coronavirus as the cause of diseases classified elsewhere (B97.2-)
  • pneumonia due to SARS-associated coronavirus (J12.81)

Where it sits Source: CMS/NCHS

Under:Chapter 22: Codes for special purposesU00-U49 Provisional assignment of new diseases of uncertain etiology or emergency useU07 Emergency use of U07

Most relevant related codes MedCoder-derived

Read off the official notes above and this code’s own position in the tabular list. Which to report is a documentation question; Compare shows the two side by side.

CompareCheck ClaimView Related Codes

Inpatient Payment Groups (MS-DRG)

Potential MS-DRG participation — not a DRG assignment.

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v44, Appendix B.

  • MS-DRG 177 — RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC (MDC 04)
  • MS-DRG 178 — RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC (MDC 04)
  • MS-DRG 179 — RESPIRATORY INFECTIONS AND INFLAMMATIONS WITHOUT CC/MCC (MDC 04)
  • MS-DRG 791 — PREMATURITY WITH MAJOR PROBLEMS (MDC 15)
  • MS-DRG 793 — FULL TERM NEONATE WITH MAJOR PROBLEMS (MDC 15)
  • MS-DRG 974 — HIV WITH MAJOR RELATED CONDITION WITH MCC (MDC 25)
  • MS-DRG 975 — HIV WITH MAJOR RELATED CONDITION WITH CC (MDC 25)
  • MS-DRG 976 — HIV WITH MAJOR RELATED CONDITION WITHOUT CC/MCC (MDC 25)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for U07.1 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2027Effective: October 1, 2026

Trace:FY2027 changesChange historyRelease, file and checksum

Excludes2 — Not Included Here

Conditions not covered by this code, but which may be reported alongside it when both are present.

Use Additional Code

Supplementary codes the tabular list directs you to add.

  • Use additional code to identify pneumonia or other manifestations, such as:
  • pneumonia due to COVID-19 (J12.82)
  • Use additional code, if applicable, for associated conditions such as:
  • COVID-19 associated coagulopathy (D68.8)
  • disseminated intravascular coagulation (D65)
  • hypercoagulable states (D68.69)
  • thrombophilia (D68.69)

Coder workflow for U07.1

MedCoder structured workflow — derived from this code’s own official record

Documentation check

The provider’s diagnostic statement
Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).
The conditions the Use Additional Code note names
Reported with this code when documented; a conditional instruction (“if applicable”, “if known”) applies only when the record supports it.

Official instructions as workflow

  • Excludes2 — not part of U07.1(2 notes)

    Coding workflow: The conditions named in this note are not included in U07.1. When the record documents both, both may be reported; the note is a boundary, not a prohibition.

    CompareB97.2, J12.81

    See the official tabular notes · Guidelines I.A.12.b

  • Use Additional Code — after identifying U07.1(7 notes)

    Coding workflow: Check whether the documentation supports the additional code(s) the note names, and report them with U07.1 when it does. Where the instruction is conditional (“if applicable”, “if known”), it applies only when the record documents the condition.

    ReviewJ12.82, D68.8, D65, D68.69

    See the official tabular notes · Guidelines I.A.13

Coding decision scenarios

Pattern scenarios for this code’s structure — decision rules, not clinical cases

Documentation: A condition the Use Additional Code note names is documented.

Coding question: Is a second code reported with U07.1?

Path: Review the Use Additional Code note and the code it names.

Reason: The additional code is reported when the record documents the condition; a conditional instruction applies only when its condition is met (Guidelines I.A.13).

ReviewJ12.82, D68.8, D65, D68.69

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Don’t confuse U07.1 with…

MedCoder analysis — pairs from this code’s official notes, distinctions written by MedCoder

The codes most likely to be picked instead of U07.1 — named in its own official notes, or sharing its laterality or encounter family — with what separates them and which documentation moves the case. Each links to the full comparison.

  • B97.2— Excludes2 relationship (Informational)

    Distinct conditions — both may be reported.

    A distinct condition — both may be reported when both are documented.

    What moves you there: Documentation of coronavirus as the cause of diseases classified elsewhere adds B97.2; it is not part of this code and both may be reported when both are documented.

    Full comparison: U07.1 vs B97.2 →

  • J12.81— Excludes2 relationship (Informational)

    Distinct conditions — both may be reported.

    A distinct condition — both may be reported when both are documented.

    What moves you there: Documentation of pneumonia due to SARS-associated coronavirus adds J12.81; it is not part of this code and both may be reported when both are documented.

    Full comparison: U07.1 vs J12.81 →

Relationships are read from this code's own official notes, its laterality siblings and its encounter family; the wording of each distinction is MedCoder editorial, and the documentation named in each “what moves you there” line is the official note phrase or sibling title itself. Source: CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a.

Coding context

Guidelines, coding notes, decision aids, relationships (with MS-DRG and CCSR classification), hierarchy, HCC, coverage and the context map: what a coder reaches for after the core. Each section names whether it is official source data, a MedCoder-derived relationship or MedCoder editorial.

Code Overview

COVID-19 is a billable ICD-10-CM diagnosis code (U07.1).

MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.

Official Coding Guidelines

Official source data — quoted verbatim from the CMS/NCHS Official Guidelines

Verbatim excerpts from the ICD-10-CM Official Guidelines for Coding and Reporting (CMS/NCHS) that govern this code.

Chapter 1: Certain Infectious and Parasitic Diseases (A00-B99), U07.1, U09.9 a. Human Immunodeficiency Virus (HIV) Infections 1) Code only confirmed cases

(a) Code only confirmed cases Code only a confirmed diagnosis of the 2019 novel coronavirus disease (COVID-19) as documented by the provider. For a confirmed diagnosis, assign code U07.1, COVID-19. This is an exception to the hospital inpatient guideline Section II, H. In this context, “confirmation” does not require documentation of a positive test result for COVID-19; the provider’s documentation that the individual has COVID-19 is sufficient.

Chapter 1: Certain Infectious and Parasitic Diseases (A00-B99), U07.1, U09.9 a. Human Immunodeficiency Virus (HIV) Infections 1) Code only confirmed cases

If the provider documents "suspected," "possible," "probable," or “inconclusive” COVID-19, do not assign code U07.1. Instead, code the signs and symptoms reported. See guideline I.C.1.g.1.g.

Chapter 1: Certain Infectious and Parasitic Diseases (A00-B99), U07.1, U09.9 a. Human Immunodeficiency Virus (HIV) Infections 1) Code only confirmed cases

(b) Sequencing of codes When COVID-19 meets the definition of principal diagnosis, code U07.1, COVID-19, should be sequenced first, followed by the appropriate codes for associated manifestations, except when another guideline requires that certain codes be sequenced first, such as obstetrics, sepsis, or transplant complications.

Chapter 1: Certain Infectious and Parasitic Diseases (A00-B99), U07.1, U09.9 a. Human Immunodeficiency Virus (HIV) Infections 1) Code only confirmed cases

(c) Acute respiratory manifestations of COVID-19 When the reason for the encounter/admission is a respiratory manifestation of COVID-19, assign code U07.1, COVID-19, as the principal/first-listed diagnosis and assign code(s) for the respiratory manifestation(s) as additional diagnoses.

Chapter 1: Certain Infectious and Parasitic Diseases (A00-B99), U07.1, U09.9 a. Human Immunodeficiency Virus (HIV) Infections 1) Code only confirmed cases

(i) Pneumonia For a patient with pneumonia confirmed as due to COVID-19, assign codes U07.1, COVID-19, and J12.82, Pneumonia due to coronavirus disease 2019. (ii) Acute bronchitis For a patient with acute bronchitis confirmed as due to COVID-19, assign codes U07.1, and J20.8, Acute bronchitis due to other specified organisms.

Chapter 1: Certain Infectious and Parasitic Diseases (A00-B99), U07.1, U09.9 a. Human Immunodeficiency Virus (HIV) Infections 1) Code only confirmed cases

Bronchitis not otherwise specified (NOS) due to COVID- 19 should be coded using code U07.1 and J40, Bronchitis, not specified as acute or chronic. (iii)Lower respiratory infection If the COVID-19 is documented as being associated with a lower respiratory infection, not otherwise specified (NOS), or an acute respiratory infection, NOS, codes U07.1 and J22, Unspecified acute lower respiratory infection, should be assigned.

Chapter 1: Certain Infectious and Parasitic Diseases (A00-B99), U07.1, U09.9 a. Human Immunodeficiency Virus (HIV) Infections 1) Code only confirmed cases

If the COVID-19 is documented as being associated with a respiratory infection, NOS, codes U07.1 and J98.8, Other specified respiratory disorders, should be assigned.

Chapter 1: Certain Infectious and Parasitic Diseases (A00-B99), U07.1, U09.9 a. Human Immunodeficiency Virus (HIV) Infections 1) Code only confirmed cases

(iv) Acute respiratory distress syndrome For acute respiratory distress syndrome (ARDS) due to COVID-19, assign codes U07.1, and J80, Acute respiratory distress syndrome.

Verify Before Coding

  • MCC as a secondary diagnosis (FY2027). Can raise the stay's MS-DRG severity tier.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Relationships & Classification

MedCoder-derived relationships — computed from published CMS and AHRQ datasets

MS-DRG Grouper Relationships (FY2027)

Potential MS-DRG participation — not a DRG assignment.

FY2027 MS-DRG: MCC — Major Complication or Comorbidity. Reported as a secondary diagnosis, this code raises the stay's MS-DRG severity tier — except when the principal diagnosis is one of 1 clinically related codes on its CMS exclusion list. Does not count toward severity when the stay groups to DRGs 974-976 (HIV with Major Related Condition).

Named in the grouper logic of 8 MS-DRGs: DRG 177 (MDC 04), DRG 178 (MDC 04), DRG 179 (MDC 04), DRG 791 (MDC 15), DRG 793 (MDC 15), DRG 974 (MDC 25), DRG 975 (MDC 25), DRG 976 (MDC 25).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):INF012 — COVID-19 (default).

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Related Codes

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (COVID-19).

J12.82 — Pneumonia due to coronavirus disease 2019, U09.9 — Post COVID-19 condition, unspecified

Same Index main term, other category

The ICD-10-CM Index to Diseases and Injuries files this code under the main terms “COVID-19”, “Coronavirus”; these codes share that main term but sit in a different category of the Tabular List.

B97.21 — SARS-associated coronavirus as the cause of diseases classified elsewhere (SARS-associated), B97.29 — Other coronavirus as the cause of diseases classified elsewhere (as cause of disease classified elsewhere), J12.82 — Pneumonia due to coronavirus disease 2019 (pneumonia), U09.9 — Post COVID-19 condition, unspecified (long), Z11.52 — Encounter for screening for COVID-19 (screening), Z20.822 — Contact with and (suspected) exposure to COVID-19 (contact), Z28.310 — Unvaccinated for COVID-19 (unvaccinated), Z28.311 — Partially vaccinated for COVID-19 (partially vaccinated), Z86.16 — Personal history of COVID-19 (history of)

Lab tests where this diagnosis supports Medicare coverage (NCD)

Medicare's National Coverage Determination (NCD) program lists this diagnosis as medical justification for these lab tests.

Blood Glucose Test, Fecal Occult Blood Test (FOBT), Iron Panel, Thyroid Stimulating Hormone (TSH)

Contextual Map

Every relationship of U07.1 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Run U07.1 with these 6 related codes in Claim Check

Hierarchy

Excludes2

Use Additional Code

Clinical classification (CCSR)

MS-DRG Grouper

MDC crossing

  • MDC 04 — Diseases and Disorders of the Respiratory System[MDC crossing]: “Diseases and Disorders of the Respiratory System — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs. 4,000 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2027
  • MDC 15 — Newborns and Other Neonates with Conditions Originating in Perinatal Period[MDC crossing]: “Newborns and Other Neonates with Conditions Originating in Perinatal Period — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs.”— CMS MS-DRG Definitions Manual · FY2027

Index entries (9)

  • Coronavirus (infection), 2019[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Coronavirus (infection), coronavirus-19[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Coronavirus (infection), COVID-19[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • COVID-19[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Disease, diseased, COVID-19[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Infection, infected, infective (opportunistic), coronavirus-2019[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Infection, infected, infective (opportunistic), COVID-19[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Infection, infected, infective (opportunistic), virus, viral NOS, COVID-19[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • and 1 more

Nearest codes

Change history

Reference

Index terms and tables, published questions and FAQ, every source behind this page with its release and checksum, the date-of-service check and the complete change history.

Indexed Clinical Terms (9)

Official source data — entries quoted as published, in the Index’s own lookup phrasing

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code. These are alphabetic-index entries shown as the Index writes them — lookup phrasing, not necessarily the wording of a final diagnosis.

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data
CMS/CDC ICD-10-CM FY2027 tabular list, index and tables, effective October 1, 2026 Release, file and checksum · Publisher’s page
Coding guidelines Official source data
ICD-10-CM Official Guidelines for Coding and Reporting (FY2027), quoted by section Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v44.0 (October 2026) Release, file and checksum · Publisher’s page
Inpatient payment groups Official source data
CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v44 Release, file and checksum · Publisher’s page
Change history and date-of-service validity Official source data
CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
Comparisons, relationships and the contextual map MedCoder-derived relationship
Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
Summary and FAQ answers MedCoder editorial explanation
Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Current data releases:ICD-10-CM FY2027 · ICD-10-PCS FY2027 · HCPCS October 2026 · MS-DRG v44 · Medicare Code Editor v44.0 · NCCI PTP Q4 2026 · MUE Q4 2026 · NCD code lists 2026-01 · LCD export September 28, 2026 · All releases and sources

Labels on this page: Official source data · MedCoder-derived relationship · MedCoder editorial explanation. How to read the labels · All data sources and release dates · CMS coding rules

Cite this page

Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.

MedCoder.ai. "U07.1 — COVID-19." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/u07.1-covid-19

Change history

Nearest Codes in This Family

Official ICD-10-CM classifications closest to U07.1 in its code family, with their registry titles.

View all codes in the U07 family