Administrative claims may provide an understanding of the clinical and economic burden of novel coronavirus disease 2019 (COVID-19). However, their limited sensitivity in identifying conditions, such as sepsis, suggests the need to assess whether billing codes reliably capture COVID-19 discharges.
A new diagnosis code for COVID-19 (International Statistical Classification of Diseases, Tenth Revision, Clinical Modification [ICD-10-CM] code U07.1) was introduced on April 1, 2020, to facilitate billing and case monitoring. For discharges prior to April 1, 2020, the Centers for Disease Control and Prevention advised coding for the clinical syndrome (eg, pneumonia) and “other coronavirus as the cause of diseases classified elsewhere” (ICD-10-CM code B97.29).
We examined the uptake in COVID-19–specific coding (ICD-10-CM code U07.1), the transition from legacy coding, and the accuracy of the COVID-19–specific code using severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) polymerase chain reaction (PCR) testing as the reference standard.