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

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** it's only the primary if it meets the criteria in [[Primary Admit Diagnosis]], e.g. if they also have a stroke or trauma COVID might not be related to primary at all
** it's only the primary if it meets the criteria in [[Primary Admit Diagnosis]], e.g. if they also have a stroke or trauma COVID might not be related to primary at all
** code the infection as primary, not the pathogen
** code the infection as primary, not the pathogen
*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.
*This is a code for a viral pathogen officially called "SARS-COV-2".  It causes a disease called "COVID-19", that has multiple infectious 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-COV-2)]].   
**The main manifestation known as of January 2021 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.
**Code a person with "COVID-19–related multisystem inflammatory syndrome" by linking [[COVID-19 (SARS-COV-2)]] to  [[Disorder of the immune system, NOS]].  IF we see many more of these in the future, we will consider adopting the specific code for it U07.3.
{{DA | 1
* Coding as [[Disorder of the immune system, NOS]] will not work because a pathogen can only be coded with an infectious disease, and that is not. We could set it as infectious disease, but that defeats the purpose of the categorization and the cross check. [[User:Ttenbergen|Ttenbergen]] 13:51, 2021 January 12 (CST)
}}
**If you have an asymptomatic patient who has tested positive, you can link this with [[Carrier of infectious disease, unspecified]].
**If you have an asymptomatic patient who has tested positive, you can link this with [[Carrier of infectious disease, unspecified]].
**If you have a covid positive patient with GI symptoms only, you can combine with [[Gastrointestinal infection (gastroenteritis, colitis), viral]]
**If you have a covid positive patient with GI symptoms only, you can combine with [[Gastrointestinal infection (gastroenteritis, colitis), viral]]
*Once active infection is gone (even if manifestations such as respiratory fibrosis and respiratory failure remain and continue to be coded) we will NOT code it.  Specifically, as the WHO has not seen fit to create an ICD-10 code for past history of COVID-19, we won’t either.  Thus, this code should not be used as a comorbid diagnosis.
*Once active infection is gone (even if manifestations such as respiratory fibrosis and respiratory failure remain and continue to be coded) we will NOT use this code.  Specifically, we do not have a coded for past history of COVID-19.  Thus, this code should not be used as a comorbid diagnosis. Also, do not use this to code non-infectious complications or sequelae of COVID-19 (see '''[[Post COVID-19 condition]]'''


== Data Collection Instructions ==
== Data Collection Instructions ==

Revision as of 16:35, 12 January 2021

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:
External ICD10 Documentation

This diagnosis is a part of ICD10 collection.

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    • 2019-01-01
    • 2999-12-31
    • U07.1
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Additional Info

  • Follow the same rules as usual for Primary Admit Diagnosis; that way our long term reporting doesn't get any weird discontinuities and if we need to report something for COVID we can still find that it was associated with the same priority:
    • it's only the primary if it meets the criteria in Primary Admit Diagnosis, e.g. if they also have a stroke or trauma COVID might not be related to primary at all
    • code the infection as primary, not the pathogen
  • This is a code for a viral pathogen officially called "SARS-COV-2". It causes a disease called "COVID-19", that has multiple infectious manifestations, with more likely to be identified over time.
  • Once active infection is gone (even if manifestations such as respiratory fibrosis and respiratory failure remain and continue to be coded) we will NOT use this code. Specifically, we do not have a coded for past history of COVID-19. Thus, this code should not be used as a comorbid diagnosis. Also, do not use this to code non-infectious complications or sequelae of COVID-19 (see Post COVID-19 condition

Data Collection Instructions

Will be used for MCHP (Manitoba Center for Health Policy)

Data about COVID is sent to MCHP so please adhere to the guidelines below closely so our data is well understood.

Coding Suspected infection

If patient is a COVID suspect- combine COVID-19 (SARS-COV-2) with Observation for suspected infection NOS linked with the same number (don’t link it with any other infection code if not confirmed) Leave the code in, even if they later come up as a negative.

Coding symptomatic infection

COVID positive patients- combine COVID-19 (SARS-COV-2) with other appropriate diagnosis such as Pneumonia, viral, ARDS (noncardiogenic pulmonary edema)

Coding asymptomatic infection

Combine COVID-19 (SARS-COV-2) with Carrier of infectious disease, unspecified

Coding hospital acquired COVID

Add Nosocomial_infection,_NOS to what you would already code for this infection (ie might be different if symptomatic or not, or suspected etc, use the rules described elsewhere for that part).

Isolation

Enter CCI Isolation, infectious if it is happening

Infection status

  • 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.

Confirmed infections

Done by Cadham Lab

Delayed lab results

Cohorting and other location located issues related to COVID

See

When info about COVID status is found out long after locations are entered

When Reviewing a chart in MR and you find a COVID positive or COVID suspect patient that occurred BEFORE the new COVID positive/suspect wards were opened, use Service Location home ward location and use the appropriate COVID-19 (SARS-COV-2) or Observation for suspected infection NOS code.

When reviewing a chart in MR and you find a COVID suspect patient on your home ward and the patient is transferred to another location where the diagnosis of COVID positive is made, check the date/time the swab was sent. If it was sent less than 48 hours after admission code this as an Admit Diagnosis, if the swab was sent greater than 48 hours after admission code this as an Acquired Diagnosis

  • how should this be done now under PatientFollow Project / Boarding Loc ? Is it even still applicable? Likely should live under Boarding Loc instead and just be linked from here? Ttenbergen 12:24, 2020 October 29 (CDT)
    • It seems this instruction is more related to differentiating between Admit Diagnosis & Acquired Diagnosis. The note about transferring location could be taken out because what we're doing for patient follow will capture the move, but the rest of the instruction still applies I would think.
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  • What are we doing for COVID recovered cases? So if MB Health considers someone to be non-infectious after 14 days, if someone is admitted to hospital >14 days from their swab date are we still coding them COVID POS? Are we using whether they are/are not isolated on admission as the deciding factor in how these are coded? Do we need a code for the recovered folks who are still needing acute care (for example patients admitted to medicine from ICU after the 14 day isolation period) Surbanski 08:21, 2020 December 10 (CST)
    • I have changed this to a Task discussion because we will need Julie and Allan for this. Could you bring it up there, please? Ttenbergen 11:26, 2020 December 10 (CST)
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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

Reporting

Main office has Form Covid_rept to report on this infection.

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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