Wiki Covid-19 follow up visit for pt with respiratory failure with hypoxia due to Covid

[Wendybird]

I have a MCR pt that had been dx with Covid who was readmitted to the hospital 9/21/20 with acute respiratory failure with hypoxia. The patient was discharged from the hospital on about 9/29/20 and was seen in our office for a follow up on 11/3/20. The physician wants to code a dx of U07.1 (Covid) and Acute respiratory failure w/ hypoxia (J96.00).

My question is- would the B97.29 code (other coronavirus as the cause of diseases classified elsewhere) apply here instead of U07.1 -or should I just use the hx code, Z87.19?

I'm also unsure on how to query the chronic vs the acute phase of the respiratory failure...

Thanks in advance for any advice!

 

[kayleeevans907]

If the patient does not still currently have covid-19 it would be inappropriate to use U07.1, I would favor the hx code as B97.29 would also imply some sort of active illness.
As far as the respiratory failure I think you will have to query your provider if it's not clear in their initial documentation.

 

[csperoni]

I have not seen any guidelines that definitively state when active becomes history for COVID 19 (in the absence of additional testing).
I would not use the history code, but rather the sequelae code B94.8. On the AHA website, they have some FAQs regarding COVID-19 diagnosis use. Here is the full link https://www.aha.org/fact-sheets/202...questions-regarding-icd-10-cm-coding-covid-19
Below is a specific question that applies to your situation.

A patient was hospitalized a few weeks ago for pneumonia due to COVID-19. The patient now presents to the emergency department with shortness of breath and is admitted. The discharge diagnosis for this admission is “pneumothorax due to a previous history of COVID-19.” How should this admission be coded? (7/22/2020)
Assign code J93.83, Other pneumothorax, as the principal diagnosis, followed by code B94.8, Sequelae of other specified infectious and parasitic diseases. In this case, the patient no longer has COVID-19 and the pneumothorax is a residual effect (sequelae). A personal history code is not appropriate because as stated in guideline I.C.21.c.4), “Personal history codes explain a patient’s past medical condition that no longer exists and is not receiving any treatment, but that has the potential for recurrence, and therefore may require continued monitoring.” The patient is clearly receiving treatment for the residual effect of COVID-19.