CoVID-19 / SARS-CoV-2 Information and Questions

[TXsweetcheeks]

@Julian
Since coding guidelines can be interpreted differently and sometimes seem contradictory, we also have Coding Clinic to refer to with those more difficult interpretations and these frequently asked questions are answered by a coding clinic advisor from AHA.

ICD-10-CM/PCS Coding Clinic, First Quarter ICD-10 2021 Pages: 25-30 Effective with discharges: March 10, 2021

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.
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.

Trust me, we have had a ton of training and education with external auditors about coding lab only positive results in the OP setting and I'm 100% sure that the governing entities made an exception to the rule of letting coders dx pts with Covid due to a positive test result.
Thank you for pointing out how differently people can interpret documentation from one view point to the next...it's not so black and white.

@Jim_in_Delaware which leads to my last and final response to you, Jimmy.
As we say in the South, "Bless your heart"
I feel like you are the one taking things the wrong way.
I'm just over here singing, dancing, and educating and I get an eye roll???
It's ok, I know it's your issue and maybe you will "get it" in your next life.

 

[AZMark]

Maybe you’re allowed to code COVID because most insurance pays for everything COVID related? This doesn’t happen with any other disease you mention.
Reading between the lines you’re still concerned about COVID cases being inflated? I don’t think they pull counts from medical billing.

Edit:
Seems straightforward, hospital is covering their ass by making sure that positive test result gets doc’d. Coder is probably the safest place to make sure that actually happens vs. relying on drs. notes.

CMS to Require Positive COVID-19 Test Results for 20-Percent Medicare Add-on Payment – MedLearn Publishing

EDITOR’S NOTE: This article, originally published on RACmonitor and ICD10monitor, has been updated to alert facilities that COVID-19 testing inclusions will have a fiscal impact starting Sept. 1, 2020. Effective Sept. 1, the Centers for Medicare & Medicaid Services (CMS) has enlisted a mandate...

icd10monitor.com

“Effective Sept. 1, the Centers for Medicare & Medicaid Services (CMS) has enlisted a mandate requiring hospitals to have positive COVID-19 laboratory tests in patients’ records to qualify for Medicare’s 20-percent add-on payment.”


Much ado about nothing.

 

[Julian]

Maybe you’re allowed to code COVID because most insurance pays for everything COVID related? This doesn’t happen with any other disease you mention.
Reading between the lines you’re still concerned about COVID cases being inflated? I don’t think they pull counts from medical billing.

Again....they are actually making it HARDER to code for covid by ruling that a doctors "probably" has covid doesn't get coded as HAS covid. While for all but 3 other conditions they would.

Allowing a positive lab test alone to code for covid isn't really a game changer, and not sure why it bothers anyone (assuming this interpretation is indeed accurate). But it does add a small amount of much needed revenue to cash strapped hospitals who've had to defer elective surgeries often throughout the pandemic.

 

[AZMark]

Again....they are actually making it HARDER to code for covid by ruling that a doctors "probably" has covid doesn't get coded as HAS covid. While for all but 3 other conditions they would.

Allowing a positive lab test alone to code for covid isn't really a game changer, and not sure why it bothers anyone (assuming this interpretation is indeed accurate). But it does add a small amount of much needed revenue to cash strapped hospitals who've had to defer elective surgeries often throughout the pandemic.

My reply was intended to be to @TXsweetcheeks string of comments

 

[Jim_in_Delaware]

@Jim_in_Delaware which leads to my last and final response to you, Jimmy.
As we say in the South, "Bless your heart"
I feel like you are the one taking things the wrong way.
I'm just over here singing, dancing, and educating and I get an eye roll???
It's ok, I know it's your issue and maybe you will "get it" in your next life.

Again, just another condescending response. Having lived in Texas, myself, for many years, I am familiar with both meanings for "Bless your heart"

I guess we are done, as you seem unable or unwilling to have a meaningful conversion on the topic.

Jim

 

[TXsweetcheeks]

Maybe you’re allowed to code COVID because most insurance pays for everything COVID related? This doesn’t happen with any other disease you mention.
Reading between the lines you’re still concerned about COVID cases being inflated? I don’t think they pull counts from medical billing.

Edit:
Seems straightforward, hospital is covering their ass by making sure that positive test result gets doc’d. Coder is probably the safest place to make sure that actually happens vs. relying on drs. notes.

CMS to Require Positive COVID-19 Test Results for 20-Percent Medicare Add-on Payment – MedLearn Publishing

EDITOR’S NOTE: This article, originally published on RACmonitor and ICD10monitor, has been updated to alert facilities that COVID-19 testing inclusions will have a fiscal impact starting Sept. 1, 2020. Effective Sept. 1, the Centers for Medicare & Medicaid Services (CMS) has enlisted a mandate...

icd10monitor.com

“Effective Sept. 1, the Centers for Medicare & Medicaid Services (CMS) has enlisted a mandate requiring hospitals to have positive COVID-19 laboratory tests in patients’ records to qualify for Medicare’s 20-percent add-on payment.”


Much ado about nothing.

Good point but I shouldn’t be able to dx a pt due to reimbursement purposes…I do not have the credentials to do that.

Here is a link: Medical Coding Is Vital to Healthcare Data Analysis I’m happy to educate anyone on medical coding because it seems that some people have the misconception that we are just “the billing guy”. I hope to enlighten anyone open to education.

You don’t learn, you don’t grow

 

[TXsweetcheeks]

@AZMark BTW your article is about 20% reimbursement for MS-DRGs (which is Inpatient admissions) based off a positive covid test. If you were a coder and you knew the guidelines you would know that Inpatient admissions can have the doctor dx Covid without a covid test and this article is saying they need that positive test to get the 20% reimbursement.
We are the county hospital but we have OP clinics that cater to the whole community with follow-up care from all specialties which include Primary care to ED to Urgent care to Day surgeries to observations to Cardio to HIV to OB to school-based to oncology to pulmonology, to behavioral health, ect. so we pretty much cater to everyone in our community.
We have Coder I, II, & III.
I am Coder I - OP coding for the clinics, ED and behavioral health so when I am coding encounters for covid tests only, it is usually due to a person being exposed or symptomatic and they just want a test and its a lab visit only.
It is a huge scope and you probably weren't aware of it but don't feel bad because a lot of people that aren't aware so I am happy to educate those who are willing to learn.

 

[Bruce]

I find it remarkable that so many posts have occurred about medical coding.

As far as I can tell coding has no result other than billing. It certainly does not make you sick or well. It does not change the status of a test result. It does not change the count of CoVID cases.

 

[TXsweetcheeks]

I find it remarkable that so many posts have occurred about medical coding.

As far as I can tell coding has no result other than billing. It certainly does not make you sick or well. It does not change the status of a test result. It does not change the count of CoVID cases.

Hi @Bruce How's it going?
Can I ask what you do for a living?

 

[Bruce]

Hi @Bruce How's it going?
Can I ask what you do for a living?

Objective analysis, computer forensics, electronic evidence handling, occasional expert witness.

As a hobby I collect CoVID data for interested epidemiologists and medical doctors.

 

[TXsweetcheeks]

@Bruce Oh cool, so your basically the IT guy.
Gotta question for you...if you drop an external hard drive on the ground while it is running and the platters get damaged...is the data really lost or can it be recovered?

 

[AZMark]

@AZMark BTW your article is about 20% reimbursement for MS-DRGs (which is Inpatient admissions) based off a positive covid test. If you were a coder and you knew the guidelines you would know that Inpatient admissions can have the doctor dx Covid without a covid test and this article is saying they need that positive test to get the 20% reimbursement.
We are the county hospital but we have OP clinics that cater to the whole community with follow-up care from all specialties which include Primary care to ED to Urgent care to Day surgeries to observations to Cardio to HIV to OB to school-based to oncology to pulmonology, to behavioral health, ect. so we pretty much cater to everyone in our community.
We have Coder I, II, & III.
I am Coder I - OP coding for the clinics, ED and behavioral health so when I am coding encounters for covid tests only, it is usually due to a person being exposed or symptomatic and they just want a test and its a lab visit only.
It is a huge scope and you probably weren't aware of it but don't feel bad because a lot of people that aren't aware so I am happy to educate those who are willing to learn.

I don’t know anything about billing. You raised an issue and it piqued my curiosity, so I read about it.
Several reputable sources cited the requirement for hospitals (where you said you work) to document a positive covid test to get full reimbursement from Medicare.
When your biggest payer, Medicare, requires a piece of data I would assume you just go ahead and record that data for all cases so you have it when needed.
You’re documenting that test. You’re not really diagnosing anyone as far as impacting their treatment.
I’m not questioning anything about your profession or it’s importance.

 

[Bruce]

@Bruce Oh cool, so your basically the IT guy.
Gotta question for you...if you drop an external hard drive on the ground while it is running and the platters get damaged...is the data really lost or can it be recovered?

Not really an IT guy. A software developer that once traveled the world but now enjoys a slower life working on civil and sometimes criminal litigation.

Typically when the heads meet the platters special coatings are scraped off leading to data loss. Sometimes platters can be transferred into another drive in a clean room allowing some or all data to be recovered. Those types of services typically cost thousands.

 

[the MfM]

Bangladesh will pay for its “support” of Russia in canceled vaccine donations

The move was a retaliation after Bangladesh abstained in the UN vote against Russia.

qz.com

 

[AZMark]

Bangladesh will pay for its “support” of Russia in canceled vaccine donations

The move was a retaliation after Bangladesh abstained in the UN vote against Russia.

qz.com

I liked the engine swap profile pic a lot better than those phallic buildings

 

[tabbibus]

da fuk with that profile picture? Wowza.

 

[tabbibus]

https://nypost.com/2022/03/09/ukraine-childrens-hospital-bombed-in-mariupol-by-russian-forces/

 

[the MfM]

da fuk with that profile picture? Wowza.

It’s a pic of the cathedral of saint basil. An Orthodox Church of which 78% Ukrainians are members. Built hundreds of years before the rise of the anti religion Soviet Union. Located in what originally was a small Ukrainian outpost known as Moscow. It is a representation of the height of religious architecture.

 

[the MfM]

This is the covid thread.

 

[tabbibus]

It’s a pic of the cathedral of saint basil. An Orthodox Church of which 78% Ukrainians are members. Built hundreds of years before the rise of the anti religion Soviet Union. Located in what originally was a small Ukrainian outpost known as Moscow. It is a representation of the height of religious architecture.

Yes. I know what it is. maybe you are too clever.