Refine ICD-10-CM reporting for COVID-19 as a secondary diagnosis

Jan. 26, 2022 / By Sue Belley, RHIA, Audrey Howard, RHIA

Twenty-two months into this pandemic and we are starting to understand how all-encompassing COVID-19 is for the inpatient. Thus, when we realize that the inpatient medical record we are coding is that of a patient with COVID-19, it is almost instinctual that we want to sequence COVID-19 as the principal diagnosis and its various manifestations as secondary diagnoses.

For many COVID-19 hospitalizations prior to the Omicron variant, COVID-19 was the reason for hospitalization, and it was the principal diagnosis in many situations. In fact, in our previous article, we reviewed some COVID-19 sequencing scenarios. But now, according to a recent Becker’s Hospital Review article, U.S. hospitals are saying that a majority of inpatients during this Omicron surge are admitted for a reason other than COVID-19 and are incidentally found to be COVID-19-positive.

The Becker’s article discusses the comments of Ashish Jha, MD, dean of Brown University’s School of Public Health in Providence, Rhode Island, on the distinction between patients hospitalized “for COVID-19” versus “with COVID-19.” The story also notes that New York Governor Kathy Hochul asked hospitals to adjust their reporting on COVID-19 hospitalizations beginning January 4, to make the distinction between those admitted for the virus as their primary condition and those who incidentally test positive.

For a complete discussion of this topic, read the full article published in JustCoding.

Sue Belley, M.Ed., RHIA, CPHQ, is the manager of clinical content development and the manager of outsource services within the Consulting Services business of 3M Health Information Systems.

Audrey Howard, RHIA, is a senior outsource services consultant with 3M Health Information Systems.