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Before we can talk about the details of COVID-19 reporting, we first must briefly discuss the science of epidemiology. The CDC defines epidemiology as "the method used to find the causes of health outcomes and diseases in populations."<ref name="CDCWhatIs16">{{cite web |url=https://www.cdc.gov/careerpaths/k12teacherroadmap/epidemiology.html |title=What is Epidemiology? |work=Teacher Roadmap |publisher=Centers for Disease Control and Prevention |date=17 June 2016 |accessdate=14 September 2021}}</ref> As we'll soon learn, finding those causes depends on quality data and reporting.
[[File:Icd10codeslogo.png|left|240px]]Related are any test reporting and billing requirements in labs and medical facilities. The [[International Statistical Classification of Diseases and Related Health Problems]] (ICD) is a commonly used system of diagnostic codes for classifying diseases, including nuanced classifications of a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances, and external causes of injury or disease. Their ICD-10-CM code set has been modified to include lab testing codes for COVID-19, as has the [[Current Procedural Terminology]] (CPT) code set. This guide provides basic information about these codes (which should not be considered legally binding advice); however, see the referenced material (and following citations) for more details concerning those codes<ref name="AMA-COVIDCPT">{{cite web |url=https://www.ama-assn.org/practice-management/cpt/covid-19-cpt-coding-and-guidance |title=COVID-19 CPT coding and guidance |work=COVID-19 CPT codes |author=American Medical Association |accessdate=14 September 2021}}</ref><ref name="AHAFreq21">{{cite web |url=https://www.codingclinicadvisor.com/faqs-icd-10-cm-coding-covid-19 |title=Frequently Asked Questions Regarding ICD-10-CM Coding for COVID-19 |work=AHA Coding Clinic Advisor |publisher=American Hospital Association |date=27 August 2021 |accessdate=14 September 2021}}</ref><ref name="CMS-ICD10CM21">{{cite web |url=https://www.cms.gov/files/document/fy-2022-icd-10-cm-coding-guidelines.pdf |format=PDF |title=ICD-10-CM Official Guidelines for Coding and Reporting FY 2022 |author=Centers for Medicare and Medicaid Services |date=10 August 2021 |accessdate=14 September 2021}}</ref><ref name="CMS-COVIDFAQFFS21">{{cite web |url=https://www.cms.gov/files/document/03092020-covid-19-faqs-508.pdf |format=PDF |title=COVID-19 Frequently Asked Questions (FAQs) on Medicare Fee-for-Service (FFS) Billing |publisher=Centers for Medicare and Medicaid Services |date=02 July 2021 |accessdate=14 September 2021}}</ref><ref name="ASCO-COVIDReport21">{{cite web |url=https://www.asco.org/sites/new-www.asco.org/files/content-files/advocacy-and-policy/documents/2020-COVID19-Billing-and-Coding-Resource.pdf |format=PDF |title=COVID-19 Coding and Reporting Information New CPT, HCPCS, and ICD-10 CM Codes |publisher=American Society of Clinical Oncology |date=26 August 2021 |accessdate=14 September 2021}}</ref>:


Epidemiology can broadly be split into two categories: descriptive epidemiology and analytical epidemiology. Descriptive epidemiology involves studies and other activities that deal with geographical comparisons and temporal trend descriptions of disease. As such, the collection and use of quality incidence data is vital to developing hypotheses.<ref name="NaitoUtil14">{{cite journal |title=Utilization and application of public health data in descriptive epidemiology |journal=Journal of Epidemiology |author=Naito, M. |volume=24 |issue=6 |pages=435–6 |year=2014 |doi=10.2188/jea.je20140182 |pmid=25327184 |pmc=PMC4213216}}</ref> Analytical epidemiology allows for the testing of those hypotheses using both experimental and observational studies, as well as control groups. Similarly, the collection and use of quality experimental and observational data is vital for proving or disproving hypotheses.<ref name="CDCPrinc12">{{cite book |url=https://www.cdc.gov/csels/dsepd/ss1978/SS1978.pdf |format=PDF |title=Principles of Epidemiology in Public Health Practice |author=Centers for Disease Control and Prevention |edition=3rd |publisher=Centers for Disease Control and Prevention |year=2012 |accessdate=11 April 2020}}</ref> In both cases, proper reporting of public health data is critical to the success of epidemiologists' response to outbreaks and pandemics, as well as the credibility of their research.<ref name="HamiltonUsing19">{{cite book |chapter=Chapter 5: Using Technologies for Data Collection and Management |title=The CDC Field Epidemiology Manual |author=Hamilton, J.J.; Hopkins, R.S. |editor=Rasmussen, S.A.; Goodman, R.A. |publisher=Oxford University Press |edition=4th |pages=71–104 |year=2019 |isbn=9780190933692}}</ref><ref name="vonElmTheStren07">{{cite journal |title=The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: Guidelines for reporting observational studies |journal=PLoS Medicine |author=von Elm, E.; Altman, D.G.; Egger, M. et al. |volume=4 |issue=10 |at=e296 |year=2007 |doi=10.1371/journal.pmed.0040296 |pmid=17941714 |pmc=PMC2020495}}</ref><ref name="Crear-PerryTheHid20">{{cite web |url=https://www.statnews.com/2020/11/05/rapid-covid-19-tests-hidden-public-health-hazard/ |title=The hidden public health hazard of rapid Covid-19 tests |author=Crear-Perry, J. |work=STAT |date=05 November 2020 |accessdate=21 November 2020}}</ref> This includes point-of-care and at-home testing results, which are at times more difficult to capture.<ref name="Crear-PerryTheHid20" />
* The CPT code 87635 has the long descriptor of "Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]), amplified probe technique." The American Medical Association's ''CPT Assistant'' [https://www.ama-assn.org/practice-management/cpt/covid-19-cpt-coding-and-guidance fact sheet] for SARS-CoV-2 reporting proves useful in supplying assistance on how and when to apply this CPT code in reporting.


The proper reporting of COVID-19 case data is no exception. In the United States, the [[Centers for Disease Control and Prevention]] (CDC) has taken a standardized approach to collecting reports on individuals with "lab-confirmed and probable cases of COVID-19,"<ref name="CDCInstruct20">{{cite web |url=https://www.cdc.gov/coronavirus/2019-ncov/downloads/COVID-19-Persons-Under-Investigation-and-Case-Report-Form-Instructions.pdf |format=PDF |title=Instructions for Completing the Human Infection with 2019 Novel Coronavirus (COVID-19) Case Report Form |author=Centers for Disease Control and Prevention |publisher=Centers for Disease Control and Prevention |date=01 May 2020 |accessdate=21 November 2020}}</ref><ref name="CDCInformRepo20">{{cite web |url=https://www.cdc.gov/coronavirus/2019-ncov/php/reporting-pui.html |title=Information for Health Departments on Reporting Cases of COVID-19 |author=Centers for Disease Control and Prevention |work=Coronavirus Disease 2019 (COVID-19) |publisher=Centers for Disease Control and Prevention |date=05 May 2020 |accessdate=21 November 2020}}</ref> noting that as of April 21, 2021, all state, territorial, and tribal jurisdictions were onboard with electronic laboratory reporting to the CDC.<ref name="CDCCOVIDELR21">{{cite web |url=https://www.cdc.gov/coronavirus/2019-ncov/lab/electronic-reporting-map.html |title=COVID-19 Electronic Laboratory Reporting Implementation by State |author=Centers for Disease Control and Prevention |publisher=Centers for Disease Control and Prevention |date=20 April 2021 |accessdate=19 September 2021}}</ref> Their COVID-19 Surveillance Worksheet (formerly Case Report Form) is designed to collect a wide variety of information about a COVID-19 case, including patient demographics, epidemiological characteristics, exposure and contact history, clinical diagnosis, treatment procedures, and vaccination history. Currently, the CDC is asking healthcare providers and [[Laboratory|laboratories]] that are operating as testing sites to "report data for all diagnostic and screening testing completed, which includes molecular, antigen, and antibody testing, for each individual tested" on a daily basis, "within 24 hours of test completion."<ref name="CDCHowToRep20">{{cite web |url=https://www.cdc.gov/coronavirus/2019-ncov/lab/reporting-lab-data.html |title=How to Report COVID-19 Laboratory Data |author=Centers for Disease Control and Prevention |publisher=Centers for Disease Control and Prevention |date=26 January 2021 |accessdate=14 September 2021}}</ref> Local, state, tribal, and territorial public health departments are then asked to submit case reports etc. to the CDC. Electronic reporting using the CDC's system is preferred, but they have a protocol for those areas unable to submit electronically. Recognizing the disparate reporting mechanisms across various state health departments and the problems this causes, particularly during an epidemic, funding efforts are under way to assist the CDC—as well as state, local, and tribal governments—better report disease information through a modernized, centralized public health data management platform.<ref name="Crear-PerryTheHid20" /><ref name="CDCCentral20">{{cite web |url=https://sam.gov/opp/f0fc727c642640ed829d98fc880d4713/view |title=Centralized National Reporting Mechanism for COVID-19 Laboratory Tests Results and Other Reportable Conditions, United States |author=Centers for Disease Control and Prevention |work=SAM.gov |date=16 November 2020 |accessdate=14 September 2021}}</ref>
* Since the pandemic has progressed, numerous other CPT codes have become available. This includes a series of parent and child codes for antibody testing, neutralizing antibody screens, antigen testing, and vaccination. Resources for guidance concerning these codes include the [https://www.ama-assn.org/practice-management/cpt/covid-19-cpt-coding-and-guidance American Medical Association] and the [https://www.asco.org/sites/new-www.asco.org/files/content-files/advocacy-and-policy/documents/2020-COVID19-Billing-and-Coding-Resource.pdf American Society of Clinical Oncology] (PDF).


Elsewhere, Canada has similar reporting expectations to the U.S. CDC, with their own case report form and electronic data submission process through the Public Health Agency of Canada.<ref name="CanadaInterim20">{{cite web |url=https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/health-professionals/interim-guidance-surveillance-human-infection.html |title=National surveillance for Coronavirus disease (COVID-19) |author=Government of Canada |publisher=Government of Canada |date=19 March 2021 |accessdate=14 September 2021}}</ref> And in the European Union, member countries and the U.K. are asked to report through the Early Warning and Response System, with "additional enhanced surveillance ... established through The European Surveillance System - TESSy."<ref name="ECDCCaseDef20">{{cite web |url=https://www.ecdc.europa.eu/en/covid-19/surveillance |title=EU level surveillance of COVID19 |author=European Centre for Disease Prevention and Control |publisher=European Centre for Disease Prevention and Control |work=COVID-19 Portal |date=29 May 2020 |accessdate=21 November 2020}}</ref>
* The U.S. government-adopted ICD-10-CM—an authorized version of WHO's ICD-10<ref name="CDCIntern20">{{cite web |url=https://www.cdc.gov/nchs/icd/icd10cm.htm |title=International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) |author=National Center for Health Statistics |publisher=Centers for Disease Control and Prevention |date=30 July 2021 |accessdate=14 September 2021}}</ref>—has been updated by the CDC and the National Center for Healthcare Statistics. It includes not only codes for conditions associated with COVID-19, but also codes for exposure, screening, and vaccination. The principal diagnosis code "U07.1, COVID-19" is sequenced first for a confirmed COVID-19 diagnosis, followed by any appropriate codes for associated manifestations (though there is an obstetrics exception). CMS's [https://www.cms.gov/files/document/fy-2022-icd-10-cm-coding-guidelines.pdf coding guidelines], as well as [https://www.ama-assn.org/practice-management/cpt/covid-19-cpt-coding-and-guidance American Medical Association] guidance, may prove useful in choosing the correct codes. The [https://www.asco.org/sites/new-www.asco.org/files/content-files/advocacy-and-policy/documents/2020-COVID19-Billing-and-Coding-Resource.pdf American Society of Clinical Oncology] (PDF) is also maintaining a document with ICD-10-CM information.
 
* Since the pandemic started, new HCPCS codes have been released by the Centers for Medicare & Medicaid Services (CMS). These are to be used solely for Medicare claims. The [https://www.asco.org/sites/new-www.asco.org/files/content-files/advocacy-and-policy/documents/2020-COVID19-Billing-and-Coding-Resource.pdf American Society of Clinical Oncology] (PDF) is maintaining a helpful document with that information.
 
Laboratories analyzing specimens for SARS-CoV-2 must be equipped to implement and handle analytical testing and test orders using the new test codes. However, they also must be able to quickly and accurately transfer vital case information to the appropriate health authority. This may include using other types of codes such as Logical Observation Identifiers Names and Codes ([[LOINC]]) and [[SNOMED-CT codes]], which are briefly discussed in the next subsection.


==References==
==References==
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{{Reflist|colwidth=30em}}

Revision as of 20:29, 3 February 2022

Icd10codeslogo.png

Related are any test reporting and billing requirements in labs and medical facilities. The International Statistical Classification of Diseases and Related Health Problems (ICD) is a commonly used system of diagnostic codes for classifying diseases, including nuanced classifications of a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances, and external causes of injury or disease. Their ICD-10-CM code set has been modified to include lab testing codes for COVID-19, as has the Current Procedural Terminology (CPT) code set. This guide provides basic information about these codes (which should not be considered legally binding advice); however, see the referenced material (and following citations) for more details concerning those codes[1][2][3][4][5]:

  • The CPT code 87635 has the long descriptor of "Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]), amplified probe technique." The American Medical Association's CPT Assistant fact sheet for SARS-CoV-2 reporting proves useful in supplying assistance on how and when to apply this CPT code in reporting.
  • Since the pandemic has progressed, numerous other CPT codes have become available. This includes a series of parent and child codes for antibody testing, neutralizing antibody screens, antigen testing, and vaccination. Resources for guidance concerning these codes include the American Medical Association and the American Society of Clinical Oncology (PDF).
  • The U.S. government-adopted ICD-10-CM—an authorized version of WHO's ICD-10[6]—has been updated by the CDC and the National Center for Healthcare Statistics. It includes not only codes for conditions associated with COVID-19, but also codes for exposure, screening, and vaccination. The principal diagnosis code "U07.1, COVID-19" is sequenced first for a confirmed COVID-19 diagnosis, followed by any appropriate codes for associated manifestations (though there is an obstetrics exception). CMS's coding guidelines, as well as American Medical Association guidance, may prove useful in choosing the correct codes. The American Society of Clinical Oncology (PDF) is also maintaining a document with ICD-10-CM information.
  • Since the pandemic started, new HCPCS codes have been released by the Centers for Medicare & Medicaid Services (CMS). These are to be used solely for Medicare claims. The American Society of Clinical Oncology (PDF) is maintaining a helpful document with that information.

Laboratories analyzing specimens for SARS-CoV-2 must be equipped to implement and handle analytical testing and test orders using the new test codes. However, they also must be able to quickly and accurately transfer vital case information to the appropriate health authority. This may include using other types of codes such as Logical Observation Identifiers Names and Codes (LOINC) and SNOMED-CT codes, which are briefly discussed in the next subsection.

References

  1. ↑ American Medical Association. "COVID-19 CPT coding and guidance". COVID-19 CPT codes. https://www.ama-assn.org/practice-management/cpt/covid-19-cpt-coding-and-guidance. Retrieved 14 September 2021. 
  2. ↑ "Frequently Asked Questions Regarding ICD-10-CM Coding for COVID-19". AHA Coding Clinic Advisor. American Hospital Association. 27 August 2021. https://www.codingclinicadvisor.com/faqs-icd-10-cm-coding-covid-19. Retrieved 14 September 2021. 
  3. ↑ Centers for Medicare and Medicaid Services (10 August 2021). "ICD-10-CM Official Guidelines for Coding and Reporting FY 2022" (PDF). https://www.cms.gov/files/document/fy-2022-icd-10-cm-coding-guidelines.pdf. Retrieved 14 September 2021. 
  4. ↑ "COVID-19 Frequently Asked Questions (FAQs) on Medicare Fee-for-Service (FFS) Billing" (PDF). Centers for Medicare and Medicaid Services. 2 July 2021. https://www.cms.gov/files/document/03092020-covid-19-faqs-508.pdf. Retrieved 14 September 2021. 
  5. ↑ "COVID-19 Coding and Reporting Information New CPT, HCPCS, and ICD-10 CM Codes" (PDF). American Society of Clinical Oncology. 26 August 2021. https://www.asco.org/sites/new-www.asco.org/files/content-files/advocacy-and-policy/documents/2020-COVID19-Billing-and-Coding-Resource.pdf. Retrieved 14 September 2021. 
  6. ↑ National Center for Health Statistics (30 July 2021). "International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM)". Centers for Disease Control and Prevention. https://www.cdc.gov/nchs/icd/icd10cm.htm. Retrieved 14 September 2021. 
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