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This bulletin supplements the 2 bulletins released earlier this year: ICD-10-CA Coding Direction for Confirmed COVID-19 Cases and ICD-10-CA Coding Direction for Suspected COVID-19 Cases. It is intended to

  • Reinforce the correct code assignment in obstetrical cases when COVID-19 is confirmed or suspected;
  • Clarify that coders can use COVID-19 laboratory test results for the Discharge Abstract Database (DAD) and National Ambulatory Care Reporting System (NACRS); and
  • Provide new direction on the use of COVID-19 laboratory test results.

ICD-10-CA coding direction for COVID-19 in obstetrics

Confirmed COVID-19 (positive COVID-19 laboratory result) is classified to

  • O98.5– (M), (1), (2)/MP, OP Other viral diseases complicating pregnancy, childbirth and the puerperium; and
  • U07.1 (3)/OP COVID-19, virus identified.

Suspected COVID-19 (diagnosed clinically but laboratory results are inconclusive or not available, or testing is not performed) is classified to

  • O98.5– (M), (1), (2)/MP, OP Other viral diseases complicating pregnancy, childbirth and the puerperium; and
  • U07.2 (3)/OP COVID-19, virus not specified.

Do not assign O98.5– and U07.2 when COVID-19 is suspected but ruled out by negative laboratory results.

When an obstetrical patient is diagnosed with confirmed or suspected COVID-19, assign O98.5– Other viral diseases complicating pregnancy, childbirth and the puerperium as a significant diagnosis type/main problem or other problem.

Per the coding standard Complicated Pregnancy Versus Uncomplicated Pregnancy, conditions are classified to a code from Chapter XV — Pregnancy, childbirth and the puerperium when the condition poses a risk to maternal and/or fetal well-being. COVID-19 is a condition that poses a potential risk to maternal and fetal well-being.

It is mandatory to assign an additional code as a diagnosis type (3)/other problem to identify COVID-19, per the “use additional code” note at category O98 Maternal infectious and parasitic diseases classifiable elsewhere but complicating pregnancy, childbirth and the puerperium and the direction in the coding standard Use Additional Code/Code Separately Instructions.

Note: At this time, we are unable to provide direction for the classification of COVID-19 in a newborn, as we have not yet seen any documentation. If you need assistance coding a specific case, submit your question and the supporting clinical documentation via eQuery.

Use of laboratory test results for coding

Note: Per usual coding practice, use physician documentation of a positive or negative COVID-19 laboratory result to inform code assignment, even when the COVID-19 laboratory report is not available to the coder (e.g., COVID-19 testing was performed at another facility).

When COVID-19 testing is performed, both DAD and NACRS coders should code an encounter once the COVID-19 laboratory test result is available to ensure that the code assignment reflects the greatest degree of specificity known from the COVID-19–related documentation. If coding is completed before the laboratory results are available, it is recommended that you flag these charts so that code assignment can be updated once the laboratory results become available.

New direction: For cases with a diagnosis of suspected COVID-19, when available, use the most recent COVID-19 laboratory results from a continuous, uninterrupted episode of care to confirm or rule out suspected COVID-19. For the purpose of COVID-19 code assignment, “continuous, uninterrupted episode of care” includes an admission to an acute care inpatient bed from the emergency department (ED) and testing performed at an assessment centre prior to presentation at a health care facility.

For these continuous, uninterrupted episodes of care, COVID-19 laboratory results that qualify for use can originate from

  • An assessment centre to inform COVID-19 code assignment for the ED or acute care inpatient episode of care;
  • An ED to inform COVID-19 code assignment for the acute care inpatient episode of care;
  • An acute care inpatient episode of care to inform COVID-19 code assignment for the ED episode of care. 

If you need assistance coding a specific case that does not align with the direction above, submit your question and the supporting clinical documentation via eQuery.

Important: The direction to use COVID-19 laboratory test results for code assignment is currently applicable only for data collection specific to the COVID-19 pandemic. This is an exception to the direction provided in the coding standard Using Diagnostic Test Results in Coding, which excludes the use of laboratory reports in coding.

Clinical documentation infographic : Clinicians can support COVID-19 data collection for disease surveillance activities by ensuring that cases are clearly documented. Please feel free to share this infographic.

Explore CIHI’s COVID-19 resources web page, with key reports and resources on the coronavirus disease (COVID-19) pandemic.