MedicaidBilling CodesHigh impact
MAB2020052001
Pennsylvania Medicaid (DHS)·PA·Provider Bulletin
Effective date
Feb 20, 2020
We identified it
Jun 20, 2026
Summary
Pennsylvania Medical Assistance (Medicaid) providers must use specific ICD-10 codes for COVID-19 related diagnoses. New code U07.1 became effective April 1, 2020, with interim coding guidelines for encounters from February 20 - March 31, 2020.
Action Required
Immediately: Update billing system and staff training to use correct COVID-19 ICD-10 codes. For dates of service April 1, 2020 and after, use U07.1 for confirmed COVID-19. For dates February 20 - March 31, 2020, use appropriate interim codes (J12.89 + B97.29 for pneumonia, J20.8 + B97.29 for bronchitis, etc.). Train coders on specific code combinations for different COVID-19 presentations. Failure to use correct codes may result in claim denials.