COVID-19 (SARS-COV-2)

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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.

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

Coding of pneumonia in the context of COVID

  • As of May 2021, it has become clear that many or most COVID pneumonia patients are also being treated with broad spectrum antibiotics. This is despite evidence that few of these patients actually have superimposed bacterial pneumonia. There are ongoing attempts in Manitoba to get physicians to cease doing this, but it continues to occur. THUS, in someone with proven COVID pneumonia, even if the patient has been placed on antibiotics for possible bacterial pneumonia, you should NOT code bacterial pneumonia UNLESS there is clinical evidence it is present.
    • This is different than usual coding of bacterial pneumonia, where a consistent clinical picture + use of antibiotics is sufficient to code it.
    • The kinds of "evidence" you should use comes from airway/sputum cultures --- e.g. is a trach culture has lots of WBCs and grows a single organism, this is reasonable evidence (if the team is providing antibiotics). If on the other hand, the trach culture has few or moderate WBCs and grows "mixed oral flora", then this is evidence against superimposed bacterial pneumonia.
    • This gets even murkier since many patients have long-term lung infiltrates after COVID pneumonia, which is usually NOT infectious but USUALLY represents pneumonitis and/or fibrosis, but CAN represent superimposed secondary infection.
    • Bottom line on all this is you need to use your judgement, but do NOT code a bacterial pneumonia just because the docs are writing "post-COVID" pneumonia. See below for more info about that.

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.

This should be coded on admission (if applicable) but subsequent swabs sent during the admission should not be coded as acquired diagnosis, unless the Swab is positive, then follow the usual guidelines for coding an acquired infection.

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

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

No special rules for COVID, just use the normal Admit Diagnosis & Acquired Diagnosis rules.

Post-COVID

  • If appropriate, code Post COVID-19 condition
    • See Post COVID-19 condition for how to handle the fact that some physicians are (confusingly) writing things like "post-COVID pneumonia" or "post-COVID pneumonitis" to indicate ongoing, noninfectious pulmonary sequelae after the active COVID infection itself is gone.
  • If after COVID-19 has run its course there are no sequelae, then like any other acute issue that has disappeared, then don't code anything else.

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
Check ICD10 some cant be primaryCCMDB.accdbneeds review
Query check ICD10 duplicatesCCMDB.accdbready to implement

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