The daily news surrounding COVID-19 includes information and facts from those individuals who were diagnosed with COVID-19 but they now are in the recovery stage and have “Post-COVID-19” signs and symptoms.  A recent study in Nature Medicine (March 22, 2021), titled, “Post-Acute COVID-19 Syndrome”, states the following:

Acute COVID-19 usually lasts until 4 weeks from the onset of symptoms, beyond which replication-competent SARS-CoV-2 has not been isolated. Post-acute COVID-19 is defined as persistent symptoms and/or delayed or long-term complications beyond 4 weeks from the onset of symptoms.

Individuals are experiencing a variety of signs and symptoms post-acute COVID-19 up to and beyond 6 months after. The Post-Acute COVID-19 signs/symptoms includes the following:

  • Fatigue                                                                            
  • Muscular weakness                                                     
  • Dyspnea                                                                          
  • Persistent oxygen requirement                                
  • Sleep disturbances                                                       
  • Cognitive disturbances (“brain fog”)                      
  • Palpitations                                                                    
  • Thromboembolism                                                       
  • Hair Loss
  • Decline in quality of life
  • Joint pain
  • Cough
  • Anxiety/depression
  • PTSD
  • Headaches
  • Chest pain
  • Chronic Kidney disease

Read the complete report at: Post-acute COVID-19 syndrome | Nature Medicine

The post-acute COVID-19 physiological impact is crossing into many body systems, including: Respiratory (Lungs), Hepatobiliary (Liver), Gastrointestinal, Circulatory (Heart) and Neurologic (Brain). The acronym appearing in medical literature is “PACS” for Post-Acute COVID-19 Syndrome. The National Institute of Health and other organizations are conducting further research and collecting clinical data on many post-COVID-19 patients, so stay tuned regarding the continuing research on the sequelae of this virus.

Clinical coding guidelines for COVID-19 appear in the Official Guidelines for Coding and Reporting, updated January 1, 2021, in the AHA Coding Clinic on ICD-10-CM/PCS – first quarter 2021 and the AHIMA/AHA COVID-19 FAQ updated March 1, 2021, available online. All Coding and CDI professionals should take the time to stay up to date with any changes that occur. With a lot of clinical information coming at a steady pace, especially surrounding long-term sequelae we could see new codes in the future.

Striving for and achieving thorough and complete clinical documentation is essential to accurate COVID-19 coding and data integrity even for episodes after the “acute” phase of the virus has diminished. Be sure your clinical coding and data is accurate by having ongoing auditing and monitoring in place. Follow up your auditing with education as this is a best practice to ensure the new knowledge gained from the audits is really sinking in.

Written by Gloryanne Bryant, RHIA, CDIP, CCS, CCDS, AHIMA Approved ICD-10-CM/PCS Trainer

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