Case #724

WHO emergency code U07.3 and U07.4

Added by Ralph Dahlgren about 1 month ago. Updated about 10 hours ago.

Status:ActiveStart date:2020-09-03
Priority:MinorSpent time:-
Assignee:-
Category:-
Target version:-
Initiator:Iceland Target year:2021
Case type:Minor Owner / responsible:National organisations
MDC:GEN Old forum status:
Target Grouper:ICE

Description

2020-09-03 Ralph D
WHO have decided on activating two more emergency codes in the U07X area. This due to COVID-19. These codes are:
U07.3 Personal history of COVID-19
U07.4 for Multisystem inflammatory syndrome temporally related to COVID-19
These codes has to be implemented, if wanted naturally, to the different countries NordDRG system.
WHO has written as follow below in a paper:

Background
Following rounds of discussions with the CSAC (Classification and Statistics Advisory Committee), MbRG (Morbidity Reference Group) and MRG (Mortality Reference Group) and comments received, it is agreed to activate two more emergency codes for use in the context of COVID-19. The relevant updates apply to ICD-10 and ICD-11 equally.
1. U07.3 Personal history of COVID-19 This optional code serves to flag various signs, symptoms, conditions or syndromes clinically described and where a preceding diagnosis.
While there is still uncertainty of the pathophysiological relationships this code will allow the establishment of a link with COVID-19 without making assumptions about a direct relationship to it.
When using this code there are no time limitations to what a ‘history of’ is, it can be used for conditions that occur briefly after or long after COVID-19 episodes. In this way, the coding can be improved when more is known about the course of the disease.
2. U07.4 for Multisystem inflammatory syndrome temporally related to COVID-19. This code relates specifically to the more clearly defined multisystem inflammatory syndrome.

New proposed codes:
Activate emergency code for Personal history of COVID-19

1. Emergency code: U07.3
2. Title: Personal history of COVID-19
3. Description: Optional additional code used to flag cases where the mention of a preceding diagnosis of COVID-19, confirmed or probable (see case definitions) is
seen to be relevant in the context of the current condition.
Coding note: This code is only used after full recovery from COVID-19. This code is not to be used in cases tested positive at some point in time that did not
present any illness.

Activate emergency code for Multisystem Inflammatory Syndrome

1. Emergency code: U07.4
2. Title: Multisystem inflammatory syndrome.
3. Inclusion terms: Cytokine storm
Kawasaki-like syndrome
Paediatric Inflammatory Multisystem Syndrome Temporally Associated with COVID-19 (PIMS-TS)
Multi-System Inflammatory Syndrome in Children (MIS-C)
4. Exclusion terms: Mucocutaneous lymph node syndrome [Kawasaki] (M30.3)
As noted above, these codes might get different code-texts in the end.

Analysis
Department of Health and Welfare Sweden 2020-09-03
At least Sweden has no complete data on how often the two new codes will be used.
As known for now we know U07.3 Personal history of COVID-19 probably will be used much more frequent than U07.4 Multisystem inflammatory syndrome.
As many of you know Sweden has had a lot of patients in the hospital being treated for Covid-19 (SARS-CoV-2).
Very few has gotten that very serious U07.4 Multisystem inflammatory syndrome.
This means naturally that as for now Sweden at least has no cost-data concerning these two codes, has someone else?
We still think that they should get grouping properties so they can be used in our NordDRG system.
We have discussed with the Nordic Casemix Centre and we offered to make suggestions to be discussed at the meeting 2020-09-04.

Suggestion
Department of Health and Welfare Sweden 2020-09-03
Our suggestion is that the code
U07.3 Personal history of COVID-19 gets the same grouping properties as the ICD+ code Z8610 Personal history of infectious and parasitic diseases:
DGCAT 23M99 Other factors influencing health status
MDC 23 Andra och ospecificerade hälsoproblem

U07.4 Multisystem inflammatory syndrome gets the same grouping properties as the ICD+ code M3030 Mucocutaneous lymph node syndrome [Kawasaki] except PDGPRO 08P10 Arthrosis, arthritis or other connective tissue, since this is not really a typical connective tissue disease. The grouping properties would then be:
COMPL 08C02 Arteritis in connective tissue disease
DGCAT 08M23 Vasculitis or systemic connective tissue disease
DGPROP 08X99 Diseases and disorders of the musculoskeletal system and connective tissue
DGPROP 15X98 Other significant problem of neonate
MDC 08 Diseases and disorders of the musculoskeletal system and connective tissue

This above are suggestions to be discussed at the Expertmeeting 2020-09-04

Decided changes
Department of Health and Welfare Sweden 2020-09-03
Sweden wants a discussion around these codes so if possible all involved countries can in the future have the same grouping properties.
Sweden will as it looks right now include the new U07.3, U07.4 in our NordDRG system for 2021.

DRG change
There will be no movement of cases between DRG Groups, the codes are new. The cases that will be coded with the codes will be grouped to different DRGs.
When cost data comes to Sweden, in 2021 we can control if they are correctly grouped.

Technical change
For technical description see above.
Suggestion for technical changes has been made, see included Excell-file named ‘Suggested TC for U073 and U074 C855’. Correction might have to be done after the meeting.

Suggested TC for U073 and U074 C855.xlsx (17.8 KB) Ralph Dahlgren, 2020-09-03 14:59

Post-covid activation of three codes.docx (34 KB) Martti Virtanen, 2020-09-08 15:29

Adding post COVID-19 codes in ICD-10.docx (18 KB) Martti Virtanen, 2020-09-17 10:11

Grupperingsegenskaper för nya koder för Covid, nya WHO U-koder 2020-10-15.xlsx (45.9 KB) Ralph Dahlgren, 2020-10-16 08:29

History

#1 Updated by Martti Virtanen about 1 month ago

2020-09-04 Expert group
The topic was dicscussed and it was pointed out thet the proposal is only available as a draft from WHO. However, some solution will come, and the countries may consider to use the is propas for the time beeing.

#2 Updated by Martti Virtanen about 1 month ago

2020-09-08 Martti Virtanen
The latets proposal from WHO is attached. There will still be modifications.
Countries may decide to use the U07.x codes and link them later to the WHO codes. Nordcase will any way link the codes the WHO codes.

#3 Updated by Martti Virtanen about 1 month ago

2020-09-16 Expert group
The matter wa shortly dicsussed.
We will add the new codes proposed by WHO using the U07 subcodes to ICD+. This allows the countries to introduce the new codes if necesary already during this autumn. Before publication of NordDRG 2020 the new codes can easily be added to the national version. The codes may also differ from the codes we are now using as long as the concepts are roughly the same.
After the publication of the 2021 groupers any changes obviously mean that the distributed groupers need to be updated.
The added concepts and codes are:
U0710 'COVID-19, virus identified'
U0720 'COVID-19, virus not identified'
U0730 'Personal history of COVID-19'
U0740 'Post COVID-19 condition'
U0750 'Multisystem inflammatory syndrome associated with COVID-19'
If WHO decides to use 3 chracter codes instead of U0730 to U0750, NCC wil consider changing the ICD+ codes accorgingly. Thr problems can be solve by linkage.
Alread Iceland has sent us the new codes for Iceland The include U07.4 with the concept of U07.5. Therefore the reserve code u07.5 is effectively made un uspable and it has been rmoved from the ICD+ for Iceland.

#4 Updated by Martti Virtanen about 1 month ago

2020-09-17 Martti Virtanen
I got today the laest version of the added covid-19 realated codes. See attached file Adding post COVID-19 codes in ICD-10.docx

#5 Updated by Ralph Dahlgren 4 days ago

2020-10-16 Ralph Dahlgren
The file that Martti put up in this case turned out to be the correct codes from WHO.
Sweden has now gotten the codes with Swedish texts from our co-workers.
So now we enclose the swedsih codes with grouping properties that Sweden wants to be included in the Swedish definitiontables for 2021. This file only includes the WHO codes. Sorry for beeing so late.

#6 Updated by Arna Harðardóttir about 10 hours ago

  • Target Grouper ICE added
  • Initiator Iceland added

Martti Virtanen wrote:

2020-09-17 Martti Virtanen
I got today the laest version of the added covid-19 realated codes. See attached file Adding post COVID-19 codes in ICD-10.docx

Martti will you then exchange these new codes from WHO with the older ones (U07.3 and U07.4) in the national ICD versions? Iceland has this new version in its EMR.

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