TracyM_65810
New member
I am needing some further help w/ sequela in regards to COVID. I've searched forums but do not have the permissions to view one of the threads. I really don't know how to work this site. Thanks
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Resolved Sequela in regards to COVID
- Thread starter TracyM_65810
- Start date
- Status
Hey there Tracy,
Without knowing the exact late effect the only thing I can offer is that if I had someone that had a sequela from covid I would use
B94.8 "Sequelae of other specified infectious and parasitic diseases",
Without knowing the exact late effect the only thing I can offer is that if I had someone that had a sequela from covid I would use
B94.8 "Sequelae of other specified infectious and parasitic diseases",
Lori
Well-known member
Yes, that COVID thread is for CCO Club members only.
You can join here:
www.cco.us
g. Coronavirus infections
1) COVID-19 infection (infection due to SARS-CoV-2)
(a) Code only confirmed cases
Code only a confirmed diagnosis of the 2019 novel
coronavirus disease (COVID-19) as documented by
the provider or documentation of a positive
COVID- 19 test result. For a confirmed diagnosis,
assign code U07.1, COVID-19. This is an exception
to the hospital inpatient guideline Section II, H. In
this context, “confirmation” does not require
documentation of a positive test result for COVID19; the provider’s documentation that the
individual has COVID-19 is sufficient.
ICD-10-CM Official Guidelines for Coding andReporting
FY 2021
Page 29 of 126
If the provider documents "suspected,"
"possible," "probable," or “inconclusive”
COVID-19, do not assign code U07.1. Instead,
code the signs and symptoms reported. See
guideline I.C.1.g.1.g.
(b) Sequencing of codes
When COVID-19 meets the definition of principal
diagnosis, code U07.1, COVID-19, should be
sequenced first, followed by the appropriate codes
for associated manifestations, except when another
guideline requires that certain codes be sequenced
first, such as obstetrics, sepsis, or transplant
complications.
For a COVID-19 infection that progresses to sepsis,
see Section I.C.1.d. Sepsis, Severe Sepsis, and Septic
Shock
See Section I.C.15.s. for COVID-19 infection
in pregnancy, childbirth, and the puerperium
See Section I.C.16.h. for COVID-19 infection in newborn
For a COVID-19 infection in a lung transplant
patient, see Section I.C.19.g.3.a. Transplant
complications other than kidney.
(c) Acute respiratory manifestations of COVID-19
When the reason for the encounter/admission is a
respiratory manifestation of COVID-19, assign code
U07.1, COVID-19, as the principal/first-listed
diagnosis and assign code(s) for the respiratory
manifestation(s) as additional diagnoses.
The following conditions are examples of
common respiratory manifestations of COVID-19.
(i) Pneumonia
For a patient with pneumonia confirmed as due to
COVID-19, assign codes U07.1, COVID-19, and
J12.82, Pneumonia due to coronavirus disease
2019 .
ICD-10-CM Official Guidelines for Coding andReporting
FY 2021
Page 30 of 126
(ii) Acute bronchitis
For a patient with acute bronchitis confirmed as due
to COVID-19, assign codes U07.1, and J20.8, Acute
bronchitis due to other specified organisms.
Bronchitis not otherwise specified (NOS)
due to COVID-19 should be coded using
code U07.1 and J40, Bronchitis, not
specified as acute or chronic.
(iii) Lower respiratory infection
If the COVID-19 is documented as being
associated with a lower respiratory infection,
not otherwise specified (NOS), or an acute
respiratory infection, NOS, codes U07.1 and
J22, Unspecified acute lower respiratory
infection, should be assigned.
If the COVID-19 is documented as being
associated with a respiratory infection, NOS,
codes U07.1 and J98.8, Other specified
respiratory disorders, should be assigned.
(iv) Acute respiratory distress syndrome
For acute respiratory distress syndrome
(ARDS) due to COVID-19, assign codes
U07.1, and J80, Acute respiratory distress
syndrome.
(v) Acute respiratory failure
For acute respiratory failure due to
COVID-19, assign code U07.1, and code
J96.0-, Acute respiratory failure.
(d) Non-respiratory manifestations of COVID-19
When the reason for the encounter/admission is a
non-respiratory manifestation (e.g., viral enteritis)
of COVID-19, assign code U07.1, COVID-19, as the
principal/first-listed diagnosis and assign code(s) for
the manifestation(s) as additional diagnoses.
(e) Exposure to COVID-19
ICD-10-CM Official Guidelines for Coding andReporting
FY 2021
Page 31 of 126
For asymptomatic individuals with actual or suspected
exposure to COVID-19, assign code Z20.822, Contact
with and (suspected) exposure to COVID-19.
For symptomatic individuals with actual or suspected
exposure to COVID-19 and the infection has been
ruled out, or test results are inconclusive or unknown,
assign code Z20.822, Contact with and (suspected)
exposure to COVID-19. See guideline I.C.21.c.1,
Contact/Exposure, for additional guidance
regarding the use of category Z20 codes.
If COVID-19 is confirmed, see guideline I.C.1.g.1.a.
(f) Screening for COVID-19
During the COVID-19 pandemic, a screening code is
generally not appropriate. Do not assign code
Z11.52, Encounter for screening for COVID-19. For
encounters for COVID-19 testing, including
preoperative testing, code as exposure to COVID-19
(guideline I.C.1.g.1.e).
Coding guidance will be updated as new information
concerning any changes in the pandemic status
becomes available.
(g) Signs and symptoms without definitive diagnosis of
COVID-19
For patients presenting with any signs/symptoms
associated with COVID-19 (such as fever, etc.) but a
definitive diagnosis has not been established, assign the
appropriate code(s) for each of the presenting signs
and symptoms such as:
• R05 Cough
• R06.02 Shortness of breath
• R50.9 Fever, unspecified
If a patient with signs/symptoms associated with
COVID-19 also has an actual or suspected contact
with or exposure to COVID-19, assign Z20.822,
Contact with and (suspected) exposure to COVID19, as an additional code.
ICD-10-CM Official Guidelines for Coding andReporting
FY 2021
Page 32 of 126
(h) Asymptomatic individuals who test positive for
COVID-19
For asymptomatic individuals who test positive for
COVID-19, see guideline I.C.1.g.1.a. Although the
individual is asymptomatic, the individual has tested
positive and is considered to have the COVID-19
infection.
(i) Personal history of COVID-19
For patients with a history of COVID-19, assign
code Z86.16, Personal history of COVID-19.
(j) Follow-up visits after COVID-19 infection has
resolved
For individuals who previously had COVID-19 and
are being seen for follow-up evaluation, and
COVID-19 test results are negative, assign codes
Z09, Encounter for follow-up examination after
completed treatment for conditions other than
malignant neoplasm, and Z86.16, Personal history of
COVID-19.
(k) Encounter for antibody testing
For an encounter for antibody testing that is not
being performed to confirm a current COVID-19
infection, nor is a follow-up test after resolution of
COVID-19, assign Z01.84, Encounter for antibody
response examination.
Follow the applicable guidelines above if the
individual is being tested to confirm a current
COVID-19 infection.
For follow-up testing after a COVID-19 infection,
see guideline I.C.1.g.1.j.
(l) Multisystem Inflammatory Syndrome
For individuals with multisystem inflammatory
syndrome (MIS) and COVID-19, assign code
U07.1, COVID-19, as the principal/first-listed
diagnosis and assign code M35.81, Multisystem
inflammatory syndrome, as an additional
diagnosis.
ICD-10-CM Official Guidelines for Coding andReporting
FY 2021
Page 33 of 126
If MIS develops as a result of a previous COVID19 infection, assign codes M35.81, Multisystem
inflammatory syndrome, and B94.8, Sequelae of
other specified infectious and parasitic diseases.
If an individual with a history of COVID-19
develops MIS and the provider does not indicate
the MIS is due to the previous COVID-19
infection, assign codes M35.81, Multisystem
inflammatory syndrome, and Z86.16, Personal
history of COVID-19.
If an individual with a known or suspected
exposure to COVID-19, and no current COVID19 infection or history of COVID-19, develops
MIS, assign codes M35.81, Multisystem
inflammatory syndrome, and Z20.822, Contact
with and (suspected) exposure to COVID-19.
Additional codes should be assigned for any
associated complications of MIS
Sequelae (Late Effects) of External Cause Guidelines
1) Sequelae external cause codes
Sequela are reported using the external cause code with the 7th
character “S” for sequela. These codes should be used with any
report of a late effect or sequela resulting from a previous
injury.
See Section I.B.10 Sequela (Late Effects)
2) Sequela external cause code with a related current
injury
A sequela external cause code should never be used with a
related current nature of injury code.
3) Use of sequela external cause codes for subsequent
visits
Use a late effect external cause code for subsequent visits when
a late effect of the initial injury is being treated. Do not use a
late effect external cause code for subsequent visits for followup care (e.g., to assess healing, to receive rehabilitative therapy)
of the injury when no late effect of the injury has been
documented
M35.81 Multisystem inflammatory syndrome
A tabular note under code M35.81 instructs coders to use additional codes to report complications associated with multisystem inflammatory syndrome such as:
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g. Coronavirus infections
1) COVID-19 infection (infection due to SARS-CoV-2)
(a) Code only confirmed cases
Code only a confirmed diagnosis of the 2019 novel
coronavirus disease (COVID-19) as documented by
the provider or documentation of a positive
COVID- 19 test result. For a confirmed diagnosis,
assign code U07.1, COVID-19. This is an exception
to the hospital inpatient guideline Section II, H. In
this context, “confirmation” does not require
documentation of a positive test result for COVID19; the provider’s documentation that the
individual has COVID-19 is sufficient.
ICD-10-CM Official Guidelines for Coding andReporting
FY 2021
Page 29 of 126
If the provider documents "suspected,"
"possible," "probable," or “inconclusive”
COVID-19, do not assign code U07.1. Instead,
code the signs and symptoms reported. See
guideline I.C.1.g.1.g.
(b) Sequencing of codes
When COVID-19 meets the definition of principal
diagnosis, code U07.1, COVID-19, should be
sequenced first, followed by the appropriate codes
for associated manifestations, except when another
guideline requires that certain codes be sequenced
first, such as obstetrics, sepsis, or transplant
complications.
For a COVID-19 infection that progresses to sepsis,
see Section I.C.1.d. Sepsis, Severe Sepsis, and Septic
Shock
See Section I.C.15.s. for COVID-19 infection
in pregnancy, childbirth, and the puerperium
See Section I.C.16.h. for COVID-19 infection in newborn
For a COVID-19 infection in a lung transplant
patient, see Section I.C.19.g.3.a. Transplant
complications other than kidney.
(c) Acute respiratory manifestations of COVID-19
When the reason for the encounter/admission is a
respiratory manifestation of COVID-19, assign code
U07.1, COVID-19, as the principal/first-listed
diagnosis and assign code(s) for the respiratory
manifestation(s) as additional diagnoses.
The following conditions are examples of
common respiratory manifestations of COVID-19.
(i) Pneumonia
For a patient with pneumonia confirmed as due to
COVID-19, assign codes U07.1, COVID-19, and
J12.82, Pneumonia due to coronavirus disease
2019 .
ICD-10-CM Official Guidelines for Coding andReporting
FY 2021
Page 30 of 126
(ii) Acute bronchitis
For a patient with acute bronchitis confirmed as due
to COVID-19, assign codes U07.1, and J20.8, Acute
bronchitis due to other specified organisms.
Bronchitis not otherwise specified (NOS)
due to COVID-19 should be coded using
code U07.1 and J40, Bronchitis, not
specified as acute or chronic.
(iii) Lower respiratory infection
If the COVID-19 is documented as being
associated with a lower respiratory infection,
not otherwise specified (NOS), or an acute
respiratory infection, NOS, codes U07.1 and
J22, Unspecified acute lower respiratory
infection, should be assigned.
If the COVID-19 is documented as being
associated with a respiratory infection, NOS,
codes U07.1 and J98.8, Other specified
respiratory disorders, should be assigned.
(iv) Acute respiratory distress syndrome
For acute respiratory distress syndrome
(ARDS) due to COVID-19, assign codes
U07.1, and J80, Acute respiratory distress
syndrome.
(v) Acute respiratory failure
For acute respiratory failure due to
COVID-19, assign code U07.1, and code
J96.0-, Acute respiratory failure.
(d) Non-respiratory manifestations of COVID-19
When the reason for the encounter/admission is a
non-respiratory manifestation (e.g., viral enteritis)
of COVID-19, assign code U07.1, COVID-19, as the
principal/first-listed diagnosis and assign code(s) for
the manifestation(s) as additional diagnoses.
(e) Exposure to COVID-19
ICD-10-CM Official Guidelines for Coding andReporting
FY 2021
Page 31 of 126
For asymptomatic individuals with actual or suspected
exposure to COVID-19, assign code Z20.822, Contact
with and (suspected) exposure to COVID-19.
For symptomatic individuals with actual or suspected
exposure to COVID-19 and the infection has been
ruled out, or test results are inconclusive or unknown,
assign code Z20.822, Contact with and (suspected)
exposure to COVID-19. See guideline I.C.21.c.1,
Contact/Exposure, for additional guidance
regarding the use of category Z20 codes.
If COVID-19 is confirmed, see guideline I.C.1.g.1.a.
(f) Screening for COVID-19
During the COVID-19 pandemic, a screening code is
generally not appropriate. Do not assign code
Z11.52, Encounter for screening for COVID-19. For
encounters for COVID-19 testing, including
preoperative testing, code as exposure to COVID-19
(guideline I.C.1.g.1.e).
Coding guidance will be updated as new information
concerning any changes in the pandemic status
becomes available.
(g) Signs and symptoms without definitive diagnosis of
COVID-19
For patients presenting with any signs/symptoms
associated with COVID-19 (such as fever, etc.) but a
definitive diagnosis has not been established, assign the
appropriate code(s) for each of the presenting signs
and symptoms such as:
• R05 Cough
• R06.02 Shortness of breath
• R50.9 Fever, unspecified
If a patient with signs/symptoms associated with
COVID-19 also has an actual or suspected contact
with or exposure to COVID-19, assign Z20.822,
Contact with and (suspected) exposure to COVID19, as an additional code.
ICD-10-CM Official Guidelines for Coding andReporting
FY 2021
Page 32 of 126
(h) Asymptomatic individuals who test positive for
COVID-19
For asymptomatic individuals who test positive for
COVID-19, see guideline I.C.1.g.1.a. Although the
individual is asymptomatic, the individual has tested
positive and is considered to have the COVID-19
infection.
(i) Personal history of COVID-19
For patients with a history of COVID-19, assign
code Z86.16, Personal history of COVID-19.
(j) Follow-up visits after COVID-19 infection has
resolved
For individuals who previously had COVID-19 and
are being seen for follow-up evaluation, and
COVID-19 test results are negative, assign codes
Z09, Encounter for follow-up examination after
completed treatment for conditions other than
malignant neoplasm, and Z86.16, Personal history of
COVID-19.
(k) Encounter for antibody testing
For an encounter for antibody testing that is not
being performed to confirm a current COVID-19
infection, nor is a follow-up test after resolution of
COVID-19, assign Z01.84, Encounter for antibody
response examination.
Follow the applicable guidelines above if the
individual is being tested to confirm a current
COVID-19 infection.
For follow-up testing after a COVID-19 infection,
see guideline I.C.1.g.1.j.
(l) Multisystem Inflammatory Syndrome
For individuals with multisystem inflammatory
syndrome (MIS) and COVID-19, assign code
U07.1, COVID-19, as the principal/first-listed
diagnosis and assign code M35.81, Multisystem
inflammatory syndrome, as an additional
diagnosis.
ICD-10-CM Official Guidelines for Coding andReporting
FY 2021
Page 33 of 126
If MIS develops as a result of a previous COVID19 infection, assign codes M35.81, Multisystem
inflammatory syndrome, and B94.8, Sequelae of
other specified infectious and parasitic diseases.
If an individual with a history of COVID-19
develops MIS and the provider does not indicate
the MIS is due to the previous COVID-19
infection, assign codes M35.81, Multisystem
inflammatory syndrome, and Z86.16, Personal
history of COVID-19.
If an individual with a known or suspected
exposure to COVID-19, and no current COVID19 infection or history of COVID-19, develops
MIS, assign codes M35.81, Multisystem
inflammatory syndrome, and Z20.822, Contact
with and (suspected) exposure to COVID-19.
Additional codes should be assigned for any
associated complications of MIS
Sequelae (Late Effects) of External Cause Guidelines
1) Sequelae external cause codes
Sequela are reported using the external cause code with the 7th
character “S” for sequela. These codes should be used with any
report of a late effect or sequela resulting from a previous
injury.
See Section I.B.10 Sequela (Late Effects)
2) Sequela external cause code with a related current
injury
A sequela external cause code should never be used with a
related current nature of injury code.
3) Use of sequela external cause codes for subsequent
visits
Use a late effect external cause code for subsequent visits when
a late effect of the initial injury is being treated. Do not use a
late effect external cause code for subsequent visits for followup care (e.g., to assess healing, to receive rehabilitative therapy)
of the injury when no late effect of the injury has been
documented
M35.81 Multisystem inflammatory syndrome
A tabular note under code M35.81 instructs coders to use additional codes to report complications associated with multisystem inflammatory syndrome such as:
- Acute hepatic failure (K72.0-)
- Acute kidney failure (N17.-)
- Acute myocarditis (I40.-)
- Acute respiratory distress syndrome (J80)
- Cardiac arrhythmia (I47-I49.-)
- Pneumonia due to COVID-19 (J12.82)
- Severe sepsis (R65.2-)
- Viral cardiomyopathy (B33.24)
- Viral pericarditis (B33.23)
- Exposure to COVID-19 or SARS-CoV-2 infection (Z20.822)
- Personal history of COVID-19 (Z86.16)
- Sequelae of COVID-19 (B94.8)
TracyM_65810
New member
yes that code was used as primary, but the notes in icd 10 states B90-B94 are to be used to indicate conditions in categories A00-B89 as the cause of sequelae..... patient has prolonged fatigue since covid. I'm confused with which codes to use. The fatigue would be primary, but based on this NOTE I should use coronavirus infection then the B94.8. I just am not solid on this topic.
Lori
Well-known member
M35.81 Multisystem inflammatory syndrome (MIS)
These codes came out after ICD-10 was published. The guidelines I gave you were the latest updated ones.
https://www.cdc.gov/nchs/data/icd/ICD-10cmguidelines-FY2021-COVID-update-January-2021-508.pdf
ICD-10-CM Official Guidelines for Coding andReporting
FY 2021
Page 34 of 126
If MIS develops as a result of a previous COVID19 infection, assign codes M35.81, Multisystem inflammatory syndrome, and B94.8, Sequelae of
other specified infectious and parasitic diseases.
www.aappublications.org
How does this affect Coding Sequela to COVID-19?
It is all about the documentation and identifying the condition/symptom sequela to COVID-19. It is important that when coding sequela to COVID-19 any condition/symptoms that is sequela that we list all that are relevant. Be specific, documentation must include the relationship with COVID-19 in order to code the condition as sequela. Query the practitioner if the documentation is not clear. Physicians should also document any patient counseling related to prevention measures to reduce the spread of COVID-19.
Make sure when coding sequela to COVID-19, that the patient had a confirmation of COVID-19 by testing or documentation in the practitioners record. The coding guidelines tell us to code first all the condition(s) being treated that are sequela to COVID-19 (e.g., shortness of breath, DVT, fatigue, etc.) and use the additional code B94.8-Sequelae to identify the late effect. When it is unclear if the documented condition/symptoms is related to COVID-19 but there is documented confirmation the patient had COVID-19:
www.icd10monitor.com
What is a sequela? A sequela is a residual or late effect (condition-produced) after the acute phase of an illness or injury has terminated. There is no time limit on when a sequela code can be used. The residual effect may be apparent early, such as in cerebral infarction, or it may occur months or years later, such as that due to a previous illness or injury. How do we code sequelae of COVID-19?
For coding all late effects or sequelae of COVID-19, confirmed by COVID testing or documentation in the practitioner’s record indicating the patient had COVID-19:
Example: A patient is seen by his internal medicine physician in July after suffering from COVID-19 in April. The patient complains of continuous shortness of breath and fatigue, and even though the symptoms are not as severe as when he had COVID, the patient is still in discomfort.
Coding: Shortness of Breath R06.02
Fatigue R53.83-other fatigue
Sequela: B94.8
Documentation Tips for Sequela of COVID-19
It is important that when coding sequela of COVID-19, the practitioner documents that the condition is a late effect of COVID. If the practitioner’s documentation indicates multisystem inflammatory syndrome, the practitioner needs to document the affected organs in order to code correctly. If the patient is experiencing signs or symptoms that are sequelae of COVID-19, code all signs and/or symptoms that are relevant. Be specific, because documentation must include the relationship with COVID-19 in order to code the condition as a sequela. And lastly, query the practitioner if the documentation is not clear. Physicians should also document any patient counseling related to prevention measures to reduce the spread of COVID-19.
www.icd10monitor.com
These codes came out after ICD-10 was published. The guidelines I gave you were the latest updated ones.
https://www.cdc.gov/nchs/data/icd/ICD-10cmguidelines-FY2021-COVID-update-January-2021-508.pdf
ICD-10-CM Official Guidelines for Coding andReporting
FY 2021
Page 34 of 126
If MIS develops as a result of a previous COVID19 infection, assign codes M35.81, Multisystem inflammatory syndrome, and B94.8, Sequelae of
other specified infectious and parasitic diseases.
- For individuals with MIS and COVID-19, assign code U07.1, COVID-19, as the principal/first-listed diagnosis and assign code M35.81 as an additional diagnosis.
- If MIS develops as a result of a previous COVID-19 infection, assign codes M35.81 and B94.8, Sequelae of other specified infectious and parasitic diseases.
- If an individual with a history of COVID-19 develops MIS and the provider does not indicate that MIS is due to the previous COVID-19 infection, assign codes M35.81 and Z86.16.
- If an individual with a known or suspected exposure to COVID-19 and no current COVID-19 infection or history of COVID-19 develops MIS, assign codes M35.81 and Z20.822.
- Assign additional codes for any associated complications of MIS.
New COVID-19-related ICD-10-CM codes take effect | AAP News | American Academy of Pediatrics
How does this affect Coding Sequela to COVID-19?
It is all about the documentation and identifying the condition/symptom sequela to COVID-19. It is important that when coding sequela to COVID-19 any condition/symptoms that is sequela that we list all that are relevant. Be specific, documentation must include the relationship with COVID-19 in order to code the condition as sequela. Query the practitioner if the documentation is not clear. Physicians should also document any patient counseling related to prevention measures to reduce the spread of COVID-19.
Make sure when coding sequela to COVID-19, that the patient had a confirmation of COVID-19 by testing or documentation in the practitioners record. The coding guidelines tell us to code first all the condition(s) being treated that are sequela to COVID-19 (e.g., shortness of breath, DVT, fatigue, etc.) and use the additional code B94.8-Sequelae to identify the late effect. When it is unclear if the documented condition/symptoms is related to COVID-19 but there is documented confirmation the patient had COVID-19:
- Code first the condition/symptoms treated
- Report Z86.19 (personal history of other infectious and parasitic diseases) as an additional diagnosis.
Sequela Conditions from COVID-19-The Long Haulers – MedLearn Publishing
There is a term we now use for patients who are suffering from sequela conditions of COVID-19 which is Long Haulers. There are many conditions/signs symptoms and late effects of COVID-19 we are learning about every day and the list keeps growing. What are post-COVID patients experiencing? Many...
www.icd10monitor.com
What is a sequela? A sequela is a residual or late effect (condition-produced) after the acute phase of an illness or injury has terminated. There is no time limit on when a sequela code can be used. The residual effect may be apparent early, such as in cerebral infarction, or it may occur months or years later, such as that due to a previous illness or injury. How do we code sequelae of COVID-19?
For coding all late effects or sequelae of COVID-19, confirmed by COVID testing or documentation in the practitioner’s record indicating the patient had COVID-19:
- Code first all the condition(s) being treated related to COVID (e.g., shortness of breath, DVT, etc.)
- Use the additional code B94.8-Sequelae to identify the late effect.
Example: A patient is seen by his internal medicine physician in July after suffering from COVID-19 in April. The patient complains of continuous shortness of breath and fatigue, and even though the symptoms are not as severe as when he had COVID, the patient is still in discomfort.
Coding: Shortness of Breath R06.02
Fatigue R53.83-other fatigue
Sequela: B94.8
Documentation Tips for Sequela of COVID-19
It is important that when coding sequela of COVID-19, the practitioner documents that the condition is a late effect of COVID. If the practitioner’s documentation indicates multisystem inflammatory syndrome, the practitioner needs to document the affected organs in order to code correctly. If the patient is experiencing signs or symptoms that are sequelae of COVID-19, code all signs and/or symptoms that are relevant. Be specific, because documentation must include the relationship with COVID-19 in order to code the condition as a sequela. And lastly, query the practitioner if the documentation is not clear. Physicians should also document any patient counseling related to prevention measures to reduce the spread of COVID-19.
What We Currently Know about the Sequela Effects of COVID-19 – MedLearn Publishing
We are learning more every day about the sequela conditions that might arise as a result of COVID-19. The early studies have found decreased lung function that might not be reversible, as well as potentially permanent damage to the heart, kidneys, and liver, along with GI conditions. Scientists...
www.icd10monitor.com
TracyM_65810
New member
thank you so much. this helps.M35.81 Multisystem inflammatory syndrome (MIS)
These codes came out after ICD-10 was published. The guidelines I gave you were the latest updated ones.
https://www.cdc.gov/nchs/data/icd/ICD-10cmguidelines-FY2021-COVID-update-January-2021-508.pdf
ICD-10-CM Official Guidelines for Coding andReporting
FY 2021
Page 34 of 126
If MIS develops as a result of a previous COVID19 infection, assign codes M35.81, Multisystem inflammatory syndrome, and B94.8, Sequelae of
other specified infectious and parasitic diseases.
- For individuals with MIS and COVID-19, assign code U07.1, COVID-19, as the principal/first-listed diagnosis and assign code M35.81 as an additional diagnosis.
- If MIS develops as a result of a previous COVID-19 infection, assign codes M35.81 and B94.8, Sequelae of other specified infectious and parasitic diseases.
- If an individual with a history of COVID-19 develops MIS and the provider does not indicate that MIS is due to the previous COVID-19 infection, assign codes M35.81 and Z86.16.
- If an individual with a known or suspected exposure to COVID-19 and no current COVID-19 infection or history of COVID-19 develops MIS, assign codes M35.81 and Z20.822.
- Assign additional codes for any associated complications of MIS.
New COVID-19-related ICD-10-CM codes take effect | AAP News | American Academy of Pediatrics
How does this affect Coding Sequela to COVID-19?
It is all about the documentation and identifying the condition/symptom sequela to COVID-19. It is important that when coding sequela to COVID-19 any condition/symptoms that is sequela that we list all that are relevant. Be specific, documentation must include the relationship with COVID-19 in order to code the condition as sequela. Query the practitioner if the documentation is not clear. Physicians should also document any patient counseling related to prevention measures to reduce the spread of COVID-19.
Make sure when coding sequela to COVID-19, that the patient had a confirmation of COVID-19 by testing or documentation in the practitioners record. The coding guidelines tell us to code first all the condition(s) being treated that are sequela to COVID-19 (e.g., shortness of breath, DVT, fatigue, etc.) and use the additional code B94.8-Sequelae to identify the late effect. When it is unclear if the documented condition/symptoms is related to COVID-19 but there is documented confirmation the patient had COVID-19:
- Code first the condition/symptoms treated
- Report Z86.19 (personal history of other infectious and parasitic diseases) as an additional diagnosis.
Sequela Conditions from COVID-19-The Long Haulers – MedLearn Publishing
There is a term we now use for patients who are suffering from sequela conditions of COVID-19 which is Long Haulers. There are many conditions/signs symptoms and late effects of COVID-19 we are learning about every day and the list keeps growing. What are post-COVID patients experiencing? Many...
What is a sequela? A sequela is a residual or late effect (condition-produced) after the acute phase of an illness or injury has terminated. There is no time limit on when a sequela code can be used. The residual effect may be apparent early, such as in cerebral infarction, or it may occur months or years later, such as that due to a previous illness or injury. How do we code sequelae of COVID-19?
For coding all late effects or sequelae of COVID-19, confirmed by COVID testing or documentation in the practitioner’s record indicating the patient had COVID-19:
- Code first all the condition(s) being treated related to COVID (e.g., shortness of breath, DVT, etc.)
- Use the additional code B94.8-Sequelae to identify the late effect.
Example: A patient is seen by his internal medicine physician in July after suffering from COVID-19 in April. The patient complains of continuous shortness of breath and fatigue, and even though the symptoms are not as severe as when he had COVID, the patient is still in discomfort.
Coding: Shortness of Breath R06.02
Fatigue R53.83-other fatigue
Sequela: B94.8
Documentation Tips for Sequela of COVID-19
It is important that when coding sequela of COVID-19, the practitioner documents that the condition is a late effect of COVID. If the practitioner’s documentation indicates multisystem inflammatory syndrome, the practitioner needs to document the affected organs in order to code correctly. If the patient is experiencing signs or symptoms that are sequelae of COVID-19, code all signs and/or symptoms that are relevant. Be specific, because documentation must include the relationship with COVID-19 in order to code the condition as a sequela. And lastly, query the practitioner if the documentation is not clear. Physicians should also document any patient counseling related to prevention measures to reduce the spread of COVID-19.
What We Currently Know about the Sequela Effects of COVID-19 – MedLearn Publishing
We are learning more every day about the sequela conditions that might arise as a result of COVID-19. The early studies have found decreased lung function that might not be reversible, as well as potentially permanent damage to the heart, kidneys, and liver, along with GI conditions. Scientists...
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