FY 2027 MEDESUN®
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Section I.C.22 · U00-U85 · FY 2027

Chapter 22 — Codes for Special Purposes

Three codes, all governed from elsewhere: U07.0 by the respiratory chapter, U07.1 and U09.9 by the infectious disease chapter.

Dr. Santosh Kumar Guptha, CCS, CPC, COC, CIC, CRC, CPMA, CDIP, CPCO — AHIMA-Approved ICD-10-CM/PCS Trainer, MEDESUN® Medical Coding Academy Guidelines effective October 1, 2026 – September 30, 2027

Chapter 22 holds three codes, and every one of them is governed by a guideline in another chapter. U07.0 vaping-related disorder is governed by Section I.C.10.e; U07.1 COVID-19 and U09.9 post COVID-19 condition are governed by Section I.C.1.g.1.

The three U codes#

CodeTitleGoverned by
U07.0Vaping-related disorderSection I.C.10.e — Chapter 10
U07.1COVID-19Section I.C.1.g.1 — Chapter 1
U09.9Post COVID-19 condition, unspecifiedSection I.C.1.g.1.m — Chapter 1
COVID-19 — code U07.1 only for a provider-confirmed diagnosis (no test result required)Respiratory manifestationU07.1 first, then J12.82,J20.8, J22, J80, J96.0-Non-respiratory manifestationU07.1 first, then themanifestation codeSuspected, possible,probable, inconclusivedo NOT assign U07.1 —code the signs and symptomsExposure onlyZ20.822Screening: Z11.52Sequela / condition after a previous infectionthe specific condition + U09.9Personal history, no residualZ86.16 — with Z09 for a follow-up visitMIS with COVID-19U07.1 first, then M35.81Sequencing exceptions: obstetrics (O98.5- first), sepsis, and transplant complications outrank U07.1. Asymptomatic positive test with no provider diagnosis → query the provider.
The COVID-19 rules that govern U07.1 and U09.9 — Section I.C.1.g.1
SituationAssign
A patient presents with a condition related to vapingU07.0 as the principal diagnosis
Lung injury due to vapingOnly U07.0
Other manifestationsAdditional codes — acute respiratory failure J96.0-, pneumonitis J68.0
Associated respiratory signs and symptoms due to vapingNEVER Not coded separately once a definitive diagnosis has been established
Gastrointestinal symptoms such as diarrhoea and abdominal painALWAYS Appropriate to code separately

U07.1 and U09.9 — the essentials#

RuleDetail
ConfirmationCode only a confirmed diagnosis as documented by the provider. Confirmation does not require a positive test result — the provider's documentation that the individual has COVID-19 is sufficient. NEVER Do not assign U07.1 for suspected, possible, probable or inconclusive COVID-19
SequencingWhere COVID-19 meets the definition of principal diagnosis, U07.1 is sequenced first, followed by codes for associated manifestations — except where another guideline requires certain codes first, such as obstetrics, sepsis or transplant complications
U09.9 post COVID-19 conditionFor a sequela of COVID-19, or symptoms or conditions developing after a previous infection: assign codes for the specific symptoms or conditions, if known, and U09.9. NEVER U09.9 is not assigned for manifestations of an active infection
Both at onceALWAYS Where a patient has a condition associated with a previous infection and develops a new active infection, U09.9 may be assigned together with U07.1, with codes for the previous condition(s) and the new manifestation(s)

Practice questions#

Q1How many codes does the FY 2027 guideline list under Chapter 22?

  1. AOne
  2. BTwo
  3. CThree
  4. DFive
Show answer & rationale

Correct answer: C. Three

Rationale. Section I.C.22 lists three codes: U07.0 vaping-related disorder, cross-referenced to Section I.C.10.e; U07.1 COVID-19, cross-referenced to Section I.C.1.g.1; and U09.9 post COVID-19 condition, unspecified, cross-referenced to Section I.C.1.g.1.m. The chapter itself contains no independent rules.

Q2A provider documents “inconclusive COVID-19”. What is assigned?

  1. AU07.1
  2. BU09.9
  3. CThe presenting signs and symptoms
  4. DZ20.822 only
Show answer & rationale

Correct answer: C. The presenting signs and symptoms

Rationale. Section I.C.1.g.1.a states that only a confirmed diagnosis of COVID-19 as documented by the provider is coded to U07.1, and that if the provider documents suspected, possible, probable or inconclusive COVID-19, U07.1 is not assigned — the signs and symptoms reported are coded instead, per guideline I.C.1.g.1.g. Z20.822 would be added if there were actual or suspected exposure.

Q3A patient with fatigue documented as related to a COVID-19 infection last year presents with no current infection. What is assigned?

  1. AU07.1 and the fatigue code
  2. BThe fatigue code and U09.9
  3. CZ86.16 only
  4. DU09.9 only
Show answer & rationale

Correct answer: B. The fatigue code and U09.9

Rationale. Section I.C.1.g.1.m states that for a sequela of COVID-19, or associated symptoms or conditions that develop following a previous infection, a code for the specific symptom or condition related to the previous infection is assigned, if known, along with U09.9 post COVID-19 condition, unspecified, and that U09.9 should not be assigned for manifestations of an active infection.

Q4A patient presents with lung injury due to vaping and no other manifestation. What is assigned?

  1. AU07.0 and J68.0
  2. BU07.0 only
  3. CJ68.0 only
  4. DU07.0 and J96.00
Show answer & rationale

Correct answer: B. U07.0 only

Rationale. Section I.C.10.e states that for patients presenting with conditions related to vaping, U07.0 is assigned as the principal diagnosis, and that for lung injury due to vaping only code U07.0 is assigned. Additional codes are assigned for other manifestations such as acute respiratory failure or pneumonitis, but none is documented here.

Q5COVID-19 is the reason for admission for a patient at 32 weeks gestation. Which code is sequenced first?

  1. AU07.1
  2. BO98.5-
  3. CZ20.822
  4. DThe manifestation code
Show answer & rationale

Correct answer: B. O98.5-

Rationale. Section I.C.1.g.1.b states that U07.1 is sequenced first when COVID-19 meets the definition of principal diagnosis except where another guideline requires certain codes to be sequenced first, naming obstetrics, sepsis and transplant complications. Section I.C.15.s directs that during pregnancy, childbirth or the puerperium, when COVID-19 is the reason for admission, O98.5- is sequenced as the principal or first-listed diagnosis followed by U07.1 and the manifestation codes. Chapter 15 codes always take sequencing priority.

Scenarios#

Scenario 1COVID-19 that progresses to sepsis

A patient admitted with COVID-19 pneumonia develops sepsis with severe sepsis and acute respiratory failure during the stay. The provider documents the sepsis as arising from the COVID-19 infection.

Show coded answer & rationale
SeqCodeDescription
1A41.89 / the applicable sepsis codethe underlying systemic infection — sequenced per the sepsis guideline
2U07.1COVID-19
3J12.82Pneumonia due to coronavirus disease 2019
4R65.20Severe sepsis without septic shock
5J96.0-Acute respiratory failure

Rationale. Section I.C.1.g.1.b states that U07.1 is sequenced first except where another guideline requires certain codes to be sequenced first, naming sepsis among them, and cross-references Section I.C.1.d for a COVID-19 infection that progresses to sepsis. Section I.C.1.d.1.b then requires the underlying systemic infection first, followed by R65.2- and a code for each acute organ dysfunction. Verify the organism-specific sepsis code in the Tabular List, and confirm the sequencing against the circumstances of the admission and the principal diagnosis definition in Section II.

Guideline: Section I.C.1.g.1.b, I.C.1.d; Section II

Scenario 2Post COVID condition plus a new infection

A patient has persistent loss of smell documented as related to a COVID-19 infection last year, and is now diagnosed with a new active COVID-19 infection with no documented manifestation beyond the infection itself.

Show coded answer & rationale
SeqCodeDescription
1U07.1COVID-19 — the new active infection
2U09.9Post COVID-19 condition, unspecified
3R43.0Anosmia — the specific condition related to the previous infection

Rationale. Section I.C.1.g.1.m provides for exactly this combination: if a patient has a condition associated with a previous COVID-19 infection and develops a new active infection, U09.9 may be assigned together with U07.1 to identify that the patient also has a condition associated with a previous infection, with codes for the specific previous condition and for the manifestations of the new active infection also assigned.

Guideline: Section I.C.1.g.1.m

Primary sources#