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| {{ICD10 category|Pathogens}} | | {{ICD10 category|Pathogens}} |
| {{ICD10 category|Virus}} | | {{ICD10 category|Virus}} |
| | {{ICD10 category|COVID}} |
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| == Additional Info == | | == 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:
| | This is the [[Pathogen]] code for the "SARS-COV-2" virus. |
| ** 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
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| ** code the infection as primary, not the pathogen
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| *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.
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| **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)]].
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| **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.
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| **If you have an asymptomatic patient who has tested positive, you can link this with [[Carrier of infectious disease, unspecified]].
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| **If you have a covid positive patient with GI symptoms only, you can combine with [[Gastrointestinal infection (gastroenteritis, colitis), viral]]
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| *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.
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| **Thus, this code should not be used as a comorbid diagnosis.
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| **Also, do not use this to code non-infectious complications or sequelae of COVID-19 -- see '''[[Post COVID-19 condition]]'''
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| * The majority of COVID Pos patients have myalgias, fatigue, or malaise. We do not collect this as per [[Template:ICD10 Guideline Signs Symptoms Test Results not needed when cause known]]
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| == Data Collection Instructions ==
| | {{ICD10 Guideline COVID linker}} |
| === Will be used for MCHP (Manitoba Center for Health Policy) ===
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| Data about COVID is sent to MCHP so please adhere to the guidelines below closely so our data is well understood.
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| === Coding Suspected infection ===
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| 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.
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| 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.
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| === Coding symptomatic infection ===
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| '''COVID positive''' patients- combine [[COVID-19 (SARS-COV-2)]] with other appropriate diagnosis such as [[Pneumonia, viral]], [[ARDS (noncardiogenic pulmonary edema)]]
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| === Coding asymptomatic infection ===
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| Combine [[COVID-19 (SARS-COV-2)]] with [[Carrier of infectious disease, unspecified]] <!-- as discussed at Task meeting November 18, 2020 -->
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| === Coding hospital acquired COVID ===
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| 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).
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| === Isolation ===
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| Enter CCI [[Isolation, infectious]] if it is happening
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| === Infection status ===
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| *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"
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| **For example if the team believes this is likely a virus but doesn't know which one then use [[Virus, NOS]]
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| **For example if the team doesn't know what kind of bug it is, but believes it is infectious then use [[Infectious organism, unknown]]
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| ==== Presumed infections ====
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| 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]].
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| ==== Confirmed infections ====
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| Done by [[Cadham]] Lab
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| ==== Delayed lab results ====
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| *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]]
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| **Note that this test is done by [[Cadham]] Lab and not by the usual DSM lab.
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| ==== Cohorting and other location located issues related to COVID ====
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| See
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| * [[:Category:2020 COVID unit transition]]
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| * [[COVID Designated Ward]]
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| * [[Boarding Loc]]
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| ==== When info about COVID status is found out long after locations are entered ====
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| 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.
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| 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]]
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| {{TT | | |
| * 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)
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| ** 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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| *** Discussed at AJTT: no special rules for COVID, just use the normal [[Admit Diagnosis]] & [[Acquired Diagnosis]] rules. I still need to integrate this better. [[User:Ttenbergen|Ttenbergen]] 12:39, 2021 February 22 (CST)
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| }} | |
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| === Post-COVID ===
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| {{TT |
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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) [[User:Surbanski|Surbanski]] 08:21, 2020 December 10 (CST)
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| ** I have changed this to a Task discussion because we will need Julie and Allan for this. Could you bring it up there, please? [[User:Ttenbergen|Ttenbergen]] 11:26, 2020 December 10 (CST)
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| ** We added [[Post COVID-19 condition]], but some of these pt are simply recovered so would not have that. [[User:Ttenbergen|Ttenbergen]] 09:44, 2021 February 4 (CST)
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| *** [[Post COVID-19 condition]]; no remaining issues means don't code anything. I still need to integrate this. [[User:Ttenbergen|Ttenbergen]] 12:39, 2021 February 22 (CST)
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| }}
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| === Other info ===
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| * [https://en.wikipedia.org/wiki/Severe_acute_respiratory_syndrome_coronavirus_2 Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)]
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| * [https://en.wikipedia.org/wiki/Coronavirus_disease_2019 Coronavirus disease 2019 (COVID-19)]
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| == Alternate ICD10s to consider coding instead or in addition == | | == Alternate ICD10s to consider coding instead or in addition == |
| '''Only use this for COVID-19 (SARS-CoV-2)''' - not other [[Coronavirus]] | | '''Only use this for COVID-19 (SARS-CoV-2)''' - not other [[Coronavirus]] |
| | {{ListICD10Category | categoryName = COVID }} |
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| == Candidate [[Combined ICD10 codes]] == | | == Candidate [[Combined ICD10 codes]] == |
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| == Related CCI Codes == | | == Related CCI Codes == |
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| == Reporting ==
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| Main office has [[Form Covid_rept]] to report on this infection.
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| {{Data Integrity Check List}} | | {{Data Integrity Check List}} |