COVID-19 (SARS-COV-2): Difference between revisions

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== Additional Info ==
== Additional Info ==
*This is intrisically a code for a viral pathogen.  That pathogen is officially called "SARS-Cov2".  It causes a disease called COVID-19, that has multiple manifestations, with more likely to be identified over time.
*This is intrinsically a code for a viral pathogen officially called "SARS-COV-2".  It causes a disease called "COVID-19", that has multiple manifestations, with more likely to be identified over time.
**The main manifestation known as of April 2020 is a viral pneumonia which can evolve into [[ARDS (noncardiogenic pulmonary edema)]].  To code this viral pneumonia, use [[Pneumonia, viral]] with the bug being [[COVID-19 (SARS-Cov2)]].   
**The main manifestation known as of April 2020 is a viral pneumonia which can evolve into [[ARDS (noncardiogenic pulmonary edema)]].  To code this viral pneumonia, use [[Pneumonia, viral]] with the bug being [[COVID-19 (SARS-COV-2)]].   
**If as may be the case, there is a viral encephalopathy due to this bug, then you'd code it as [[Encephalitis, meningoencephalitis, myelitis, encephalomyelitis, viral]] with the bug being the same.
**If as may be the case, there is a viral encephalopathy due to this bug, then you'd code it as [[Encephalitis, meningoencephalitis, myelitis, encephalomyelitis, viral]] with the bug being the same.
*As we do with all infections, we do the best possible to identify the bug.  Sometimes we're left without a clear, laboratory identification of the bug and then we use one or another of the "wastebasket codes"
*As we do with all infections, we do the best possible to identify the bug.  Sometimes we're left without a clear, laboratory identification of the bug and then we use one or another of the "wastebasket codes"
**For example if the team believes this is likely a virus but doesn't know which one then use [[Virus, NOS]]
**For example if the team believes this is likely a virus but doesn't know which one then use [[Virus, NOS]]
**For example if the team doesn't know what kind of bug it is, but believes it is infectious then use [[Infectious organism, unknown]]
**For example if the team doesn't know what kind of bug it is, but believes it is infectious then use [[Infectious organism, unknown]]
**And if in fact even without clear cut lab confirmation, the team believes that this is COVID-19, then use [[COVID-19 (SARS-Cov2)]] as the organism -- of course anybody seeking to do definitive analysis of all COVID-19 cases will need to obtain and use the data on confirmed cases from Cadham.
 
=== Presumed infections ===
If the team believes that this is COVID-19 (even without clear cut lab confirmation), then use [[COVID-19 (SARS-COV-2)]] as the organism - of course anybody seeking to do definitive analysis of all COVID-19 cases will need to obtain and use the data on confirmed cases from Cadham.
 
=== Delayed lab results ===
*Regarding people who either die or are discharged from hospital with their COVID-19 lab test still pending, follow the usual rules i.e: [[Lab_and_culture_reports#How_long_to_wait_for_a_result]] or [[Attribution of infections]]
*Regarding people who either die or are discharged from hospital with their COVID-19 lab test still pending, follow the usual rules i.e: [[Lab_and_culture_reports#How_long_to_wait_for_a_result]] or [[Attribution of infections]]
**Note that this test is done by Cadham Lab and not by the usual DSM lab.
**Note that this test is done by Cadham Lab and not by the usual DSM lab.


== Alternate ICD10s to consider coding instead or in addition ==
=== Other info ===
'''Only use this for ''confirmed'' cases of COVID-19 (SARS-CoV-2)''' - not other [[Coronavirus]]
* [https://en.wikipedia.org/wiki/Severe_acute_respiratory_syndrome_coronavirus_2 Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)]
* [https://en.wikipedia.org/wiki/Severe_acute_respiratory_syndrome_coronavirus_2 Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)]
* [https://en.wikipedia.org/wiki/Coronavirus_disease_2019 Coronavirus disease 2019 (COVID-19)]
* [https://en.wikipedia.org/wiki/Coronavirus_disease_2019 Coronavirus disease 2019 (COVID-19)]
{{Discuss|Can this code be called COVID-19 to eliminate confusion? --[[User:Jvelasco|Jvelasco]] 08:44, 2020 March 20 (CDT)
*yes, Allan agreed and Tina to change. [[User:TOstryzniuk|Trish Ostryzniuk]]
** Just renaming this code will cause problems with cross checks.


This code is the code for a pathogen, not an infection. To use it you have to code an infection (e.g. [[Lower_respiratory_tract_infection,_acute_infectious]] ) as a combined code with this virus pathogen code, you can’t code it alone. If we want to keep it like that I can change the name to something like “SARS-CoV-2 (causes COVID19)”, but would want to keep the virus name in there.
== Alternate ICD10s to consider coding instead or in addition ==
 
'''Only use this for COVID-19 (SARS-CoV-2)''' - not other [[Coronavirus]]
If we want to code it in without combined code because it would only be used in that circumstance (eg Botulism) then we can change it to an Infection with implied pathogen. This would only allow coding it on its own, and would no longer qualify it as a pathogen. Possible drawback is that we would not know if someone e.g. had a sepsis related to it, or just breathing issues, since it would now not necessarily be coded as a disease code.
 
Third alternative is to make it into a “Double duty” code like Rabies. For that one specifically we then have Infectious contact/exposure, rabies, without disease (yet). This would allow coding this as a single code to express COVID, but also as a pathogen code to show that it was e.g. the cause of a sepsis.
}}
 
{{DiscussTask|
*I am starting to see patients who have been tested, and discharged prior to result being obtained. We currently do not have a way of finding out the test results. Is this something that we should be collecting, and if so, how would we be able to find these results?[[User:Mlagadi|Mlagadi]] 13:29, 2020 March 23 (CDT
* We will not identify someone with the code unless they have confirmed COVID-19. - Allan Garland 2020-Mar-23
** I wonder if this is more a question about how far into the future we follow labs (ie. [[Lab_and_culture_reports#How_long_to_wait_for_a_result]] or [[Attribution of infections]]. Also, we may need to integrate those better, the only reason I found them was because I knew there were pages that deal with this, so I looked for them but they were not easy to find. Ttenbergen 15:38, 2020 March 25 (CDT)
***I don't believe that Cadham lab or Provincial Microbiolgy lab, those results are shown on EPR.  Are they?  If not if a patient goes home before test result are available, we will not pull charts to find out after. However, since we are much more retrospective with our collection, then this might not be an issue?[[User:TOstryzniuk|Trish Ostryzniuk]] 17:37, 2020 March 26 (CDT)
**** You raise a good point Trish regarding results not available on EPR so even with retrospective collection at STB this is an issue unless results become available during a patients stay and the team documents in the IPN. To account for presumptive COVID cases would an ICD 10 code for these scenarios be of value to the data collection program ie. Presumed Covid? If COVID can only be coded with a confirmed positive result, and there is no code for presumptive cases, then how are the presumptive cases to be coded using current coding schemata so collectors code consistently? [[User:Ppiche|Pamela Piche]] 08:39, 2020 March 27
*****'''The question is this''':  for '''presumptive''' COVID19, how would think this is best coded?
******1. [[Pneumonia, NOS]] – with infectious organism NOS or
******2. [[Pneumonia, viral]] – combined with VIRAL NOS
*'''Allan's Reply''' --- ICD10 approach to diagnosis is to code things that are actually diagnosed.  Of course not all things diagnosed are actually TRUE, but the idea is to do the best we can.  When somebody goes home before a specific infection is diagnosed, we do not want to code things as presumptive.  Instead, do just the same as you'd do for non-COVID issues.  Of the two options above, I'd '''probably choose the 1st of them''' [[Pneumonia, NOS]] – with infectious organism NOS }}


== Candidate [[Combined ICD10 codes]] ==
== Candidate [[Combined ICD10 codes]] ==

Revision as of 13:19, 1 April 2020

ICD10 Diagnosis
Dx: COVID-19 (SARS-COV-2)
ICD10 code: U07.1
Pre-ICD10 counterpart: none assigned
Charlson/ALERT Scale: none
APACHE Como Component: none
APACHE Acute Component: none
Start Date:
Stop Date:
Data Dependencies(Reports/Indicators/Data Elements): No results
External ICD10 Documentation

This diagnosis is a part of ICD10 collection.

  • SMW
    • 2019-01-01
    • 2999-12-31
    • U07.1
  • Cargo


  • Categories
  • SMW
  • Cargo


  • Categories
  • SMW
  • Cargo


  • Categories

Additional Info

  • This is intrinsically a code for a viral pathogen officially called "SARS-COV-2". It causes a disease called "COVID-19", that has multiple manifestations, with more likely to be identified over time.
  • As we do with all infections, we do the best possible to identify the bug. Sometimes we're left without a clear, laboratory identification of the bug and then we use one or another of the "wastebasket codes"
    • For example if the team believes this is likely a virus but doesn't know which one then use Virus, NOS
    • For example if the team doesn't know what kind of bug it is, but believes it is infectious then use Infectious organism, unknown

Presumed infections

If the team believes that this is COVID-19 (even without clear cut lab confirmation), then use COVID-19 (SARS-COV-2) as the organism - of course anybody seeking to do definitive analysis of all COVID-19 cases will need to obtain and use the data on confirmed cases from Cadham.

Delayed lab results

Other info

Alternate ICD10s to consider coding instead or in addition

Only use this for COVID-19 (SARS-CoV-2) - not other Coronavirus

Candidate Combined ICD10 codes

Related CCI Codes

Data Integrity Checks (automatic list)

 AppStatus
Query check ICD10 Inf Potential Infection must have pathogen or altCCMDB.accdbdeclined
Check Inf Antibiotic resistance must have pathogen or Infection with implied pathogenCCMDB.accdbimplemented
Check Inf Infection with implied pathogen must not have a pathogen combined codeCCMDB.accdbimplemented
Query check ICD10 Inf Infection req Pathogen must have oneCCMDB.accdbimplemented
Query Check Inf Pathogens must have Infection requiring pathogen or Potential InfectionCCMDB.accdbimplemented

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