Q: Is code U07.1 always sequenced first when a patient has a COVID-related condition?
A: No. Sequencing for code U07.1 follows the circumstances of admission. If the patient was admitted and COVID-19 meets the definition of principal diagnosis, it should be sequenced first unless there is another guideline that specifies sequencing. For example, a patient admitted with COVID-19 sepsis that is present on admission is assigned a code for the sepsis as the principal diagnosis followed by code U07.1. Another example is a pregnant patient admitted with COVID-19. Chapter 15 codes take sequencing priority over codes from other chapters.
Q: Prior to April 1, 2022, can code Z28.3 for underimmunization status be used to report unvaccinated COVID patients?
A: No. Per Coding Clinic, Fourth Quarter 2021, Page 101, code Z28.3 was not intended to report partial COVID-19 vaccination or unvaccinated status. Effective April 1, 2022, this code will be expanded to accommodate reporting of COVID-19 unvaccinated and partially vaccinated patients.
Q: How should administration of Dexamethasone be reported?
A: Per Coding Clinic, 4Q 2020: Page 95, a code from table 3E0, rather than table XW0 should be used to report administration of dexamethasone. Haugen Academy recommends developing an internal organization policy on the use of this code. For example, an organization may elect to assign a code from table 3E) for dexamethasone administration only when administered for COVID-19 therapy to internally track this treatment. The substance value (6th character) for this code is Anti-inflammatory (3).
Q: Is a patient who is fully vaccinated but hasn't had the booster considered partially vaccinated?
A: At this time, there is no official guidance on how these codes will be applied and what will be considered partially vaccinated. Stay tuned to Coding Clinic for ICD-10-CM/PCS and the FAQs document from the AHA and AHIMA for official guidance (https://journal.ahima.org/ahima-and-aha-faq-on-icd-10-cm-coding-for-covid-19/).
Q: What is the difference between a third dose and a booster vaccine?
A: According to the Cleveland Clinic, a portion of the population will need a third dose of a vaccine if they are 65 or older, have risk of exposure through work, and the immunocompromised. For these people, the original dose levels are inadequate, so a third dose is given at least 28 days after the second dose. Booster vaccines are given at least 6 months after the last vaccine to increase the body’s immune response. They “remind” the immune system to make antibodies to fight COVID.
Q: How can we access the desk aid documents that Kristi referred to in the webinar?
A: All of the COVID-19 resources released by Haugen Consulting Group can be accessed at: https://www.thehaugengroup.com/about/covid-news/https://www.thehaugengroup.com/about/covid-news/. The Coding Tip Sheet for COVID-19, effective 1/1/22 and the COVID-19 Decision Tree were updated on January 10, 2022.
Updated 1/25/22
Q: In the presentation, the speaker said that the public health emergency had not been renewed, but it was renewed on January 14, 2022. Can you please clarify?
A: The presentation was recorded prior to the extension of the public health emergency. On January 14, 2022, the Secretary of HHS renewed the PHE for another 90 days. The current status of the PHE can be accessed at: https://www.phe.gov/emergency/news/healthactions/phe/Pages/default.aspx
Kristi Pollard, RHIT, CCS, CPC, CIRCC, AHIMA-Approved ICD-10-CM/PCS Trainer
Director of Coding Quality & Education
Kristi is a Director of Coding Quality & Education with more than 25 years of industry experience; she is responsible for the development of web-based, instructor-led, and webinar training materials; conducting training in ICD-10-CM/PCS and CPT; and performing DRG and APC audits. Kristi has an extensive background in coding education and consulting and is a national speaker and published writer on topics related to ICD-10 and CPT coding and code-based reimbursement. She has designed and developed training programs for inpatient and outpatient hospital-based coding, with a focus on vascular interventional radiology, interventional cardiology, orthopedics, and obstetrics.