By Matt Schlossberg
The Centers for Disease Control and Prevention’s National Center for Health Statistics (CDC/NCHS) will implement a new diagnosis code for reporting the 2019 novel coronavirus (COVID-19) effective with the next ICD-10-CM update on October 1. The CDC has released interim coding guidance to be used in conjunction with the current ICD-10-CM classification and the most recent ICD-10-CM Official Guidelines for Coding and Reporting.
According to the document, the guidance is “intended to provide information on the coding of encounters related to coronavirus. Other codes for conditions unrelated to coronavirus may be required to fully code these scenarios in accordance with the ICD-10-CM Official Guidelines for Coding and Reporting.”
Coding scenarios covered in the guidance include:
- Pneumonia case confirmed as due to COVID-19
- Acute bronchitis confirmed as due to COVID-19
- A case with COVID-19 documented as being associated with a lower respiratory infection, not otherwise specified or an acute respiratory infection, not otherwise specified
- Acute respiratory distress syndrome developed in conjunction with the COVID-19
- Cases where there is a concern about a possible exposure to COVID-19, but this is ruled out after evaluation
- Cases where there is actual exposure to someone who is confirmed to have COVID-19
The guidance document also discusses some of the signs and symptoms associated with the virus.
“AHIMA will continue to monitor new information as it becomes available to ensure that health information management professionals have the guidance and tools necessary to respond effectively to potential outbreaks in the United States with accurate coding and reporting of patients with the disease or who have been tested for the disease,” said Sue Bowman, AHIMA’s senior director of coding policy and compliance.
COVID-19 was first identified last year in Wuhan, Hubei Province, China. It has since spread to several countries in Asia, Europe, and North America. Confirmed COVID-19 infections can cause “a range of illness, from little to no symptoms, to those affected being severely ill or even dying,” according to the guidance document. Symptoms can include fever, cough, and shortness of breath. Symptoms may appear from two to 14 days after exposure, based on the incubation period for other coronaviruses, such as the MERS (Middle East Respiratory Syndrome) viruses.
As of this week, more than 79,000 cases of COVID-19 have been confirmed in 29 countries. A recent report published by China’s CDC on the first 72,314 patients with confirmed or suspected COVID-19 in mainland China found an overall case fatality rate of 2.3 percent—less deadly than SARS but more deadly than the seasonal flu. These numbers may likely drop as more undetected or mild cases are identified, according to Vox. Though the majority of cases are in China, a recent surge in confirmed cases in Italy and South Korea have sparked concerns that this is the beginning of a pandemic.
- CDC announcement regarding the new code.
- Johns Hopkins University has created an interactive web-based dashboard to visualize and track reported cases of the coronavirus in real time.
- The Regenstrief Institute is creating a series of LOINC codes to identify the lab tests used to screen patients for the virus. The team also created codes during the Zika and SARS outbreaks.
- Bulletin from the Department of Health and Human Services’ Office for Civil Rights regarding HIPAA compliance during the Covid-19 outbreak.
Matt Schlossberg is editor at the Journal of AHIMA.