Blog from March, 2020

ONC has posted a blog about adding Covid-19 Projects to the Interoperability Proving Ground https://www.healthit.gov/buzz-blog/interoperability/calling-all-covid19-health-it-projects
 
If you know of any Covid-19 specific projects please add and/or share this link https://www.healthit.gov/techlab/ipg/?tag=COVID-19

See the List

During this pandemic, those on the front lines—including health care professionals, researchers, and more—need quick, easy access to real-time critical data. This type of information exchange is what APIs do best, and as an API-first company, Postman is committed to providing whatever assistance we can in this area. Specifically, we've created a web page displaying API resources including a list of API collections that can help in the COVID-19 fight.


Information sent via email from The Postman Team on Thursday, March 26, 2020.

Forwarded to Lisa Nelson from Linda Michaelsen.

LaVerne Perlie MSN, BSN, RN announced today that ONC has listed applicable terminologies for COVID-19 tests and coded results in the Interoperability Standards Advisory (ISA) (click link) https://www.healthit.gov/isa/covid-19.  These include terms recently released by LOINC, SNOMED and CPT, and others.


LaVerne Perlie MSN, BSN, RN serves in the role of Nurse Consultant- DHHS/ONC/OPOL for theInteroperability Systems Branch of US Health and Human Services. Her email is: LaVerne.Perlie@hhs.gov

Here's a link to a dedicated LOINC SARS-CoV-2 FAQ: https://loinc.org/sars-coronavirus-2/

And LOINC prerelease terms, with all of the SARS-CoV-2 terms at the top: https://loinc.org/prerelease

This information was provided by @Swapna Abhyankar


Are any of you aware of any FHIR IG development related to COVID-19? Logica is willing to create an IG and want to make sure that we are not replicating efforts. Profiles we are thinking to include are:

  1. Labs
  2. Signs and Symptoms
  3. Pertinent Demographics

We could have the FHIR profiles created quickly if that's something we can do.  If you want to be involved in the development, reply here and indicate how you would like to be involved. Thanks...Susan

Susan A. Matney, PhD, RNC-OB, FAAN, FACMI, FHIMSS

Office +1 (801) 447-9294| Cell: +1 (801) 680-2161

email: susan.matney@imail.org

On Saturday, March 21, 2020, the eHealth Initiative sent a message to its members with a list of resources that may be useful to people tackling the coronavirus public health emergency.


Repeating them here for amplification.


  • AHIMA - New ICD-10-CM Code for COVID-19 (Link)


  • AAFP (AMERICAN ACADEMY OF FAMILY PHYSICIANS) - AAFP Raises Pressure for Federal Response to COVID-19 (Link)


  • ACOG - Are Pregnant Women at Increased Risk for COVID-19? (Link


  • ACS (AMERICAN CANCER SOCIETY) - American Cancer Society Suspends All Events until Mid-May (Link)


  • AllSCRIPTS - How to Streamline Telehealth Implementation for Safer COVID-19 Patient Encounters (Link)


  • AMAZON WEB SERVICES - Can Cloud Computing Cope With COVID-19 Demands? (Link)


  • AHA (AMERICAN HEART ASSOCIATION) - What Heart Patients Should know about COVID-19 (Link)


  • AMERICAN COLLEGE OF RADIOLOGY - Expert Radiologists Developing an AI Solution to Detect COVID-19 (Link)


  • AMERICAN COLLEGE OF PATHOLOGISTS (ACP) - COVID-19: An ACP Physician's Guide (Link)


  • BCBS (Blue Cross and Blue Shield) - Companies Announce Coverage of COVID-19 Testing for All Members (Link)


  • BOOZ ALLEN HAMILTON - NIH Selects Booz Allen to Provide Services to Support Infectious Disease Research like COVID-19. (Link)


  • CERNER - Cerner's approach to the COVID-19 pandemic (Link)     


  • CHANGE HEALTHCARE - As the COVID-19 Evolves, Change Healthcare Mobilizes Task Force to Take Swift Action to Protect Your Data. (Link)


  • CHRISTUS HEALTH - CHRISTUS Health Statement Regarding COVID-19​ (Link)


  • COLORADO RHIO - While Practicing Social Distancing CORHIO Remains Fully Operational--Providing Uninterrupted Data Exchange for Colorado. (Link)


  • EHNAC - EHNAC’s Executive Director, Lee Barrett, Comments on Finalization of HHS Rules on Interoperability and Data Blocking Regulations (Link


  • ELI LILLY - Lilly Co-develop Antibody Therapies for the Treatment of COVID-19 (Link)       ​


  • FITBIT - Fitbit Has the Ability to Track Spread of COVID-19 in Real Time (Link)


  • GOOGLE CLOUD - Google Cloud Cancels its Next Conference Due to COVID-19 (Link)


  •  HEALTH CATALYST - Health Catalyst Announces Three COVID-19 Solutions for U.S. Clients at No Incremental Cost for the Remainder of This Year. (Link)​​​


  • HEALTH CURRENT - How Health Current is Helping During the COVID-19 Crisis (Link)


  • HEALTHIX - Healthix Releases a List of Participants Currently Testing For COVID-19 (Link)


  • HOGAN LOVELLS - “Families First Coronavirus Response Act” Could Mean Massive Changes for Employers Nationwide (Link)


  • INOVALON - How Inovalon is Responding to COVID-19 (Link)


  • INTERSYSTEMS - Intersystems Provides Hospitals with Functionality to Screen for COVID-19 with TrakCare . (Link)


  • LEXISNEXIS - Lexis Practice Advisor ® has developed a Coronavirus Resource Kit. (Link)


  • LIFEWIRE - Deploying Telehealth for COVID-19​ (Link)


  • MARSHFILED CLINIC - COVID-19: What You Need to Know (Link)


  • MAYO CLINIC - COVID-19: Flattening the Curve (Link)


  • MGMA - MGMA COVID-19 Action Center (Link)


  • NATIONAL ALLIANCE OF HEALTH CARE COALITIONS - Employer Town Hall on the Coronavirus (Link)


  • NORTHWELL HEALTH - Staring Down the Coronavirus (Link)


  • OHIO HEALTH - Ohio Health Officials Address Mental Health During COVID-19 Pandemic (Link)   


  • PROVIDENCE ST. JOSEPH - Providence St. Joseph Health Offers Coronavirus Lessons from Treating 'Patient One' in the U.S. (Link)


  • STRATEGIC INTERESTS - COVID-19 Monitoring and Surveillance Solution (Link)


  • UCHICAGO MEDICINE - Coronavirus Disease 2019 (COVID-19) Information and Resources (Link)


  • UNITED HEALTHCARE (UHC) - Helping You Stay Informed About Coronavirus (Link)


  • WELLMARK - Important Health Plan Benefits Updates Regarding COVID-19 (Link)     ​


  • ZIPNOSIS - Find Out Your Risk Level of Contracting COVID-19 Zipnosis. (Link)




CPT® Category I Pathology and Laboratory Code for Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19])

CPT 87635

Effective Mar 13, 2020

A child code beneath the parent code for microbiology procedures 87471

Short:  SARS-COV-2 COVID-19 AMP PRB

Medium:  IADNA SARS-COV-2 COVID-19 AMPLIFIED PROBE TQ

Long:  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



AMA CPT COVID-19 coding and guidance
https://www.ama-assn.org/practice-management/cpt/covid-19-coding-and-guidance

Quick reference flow chart for CPT reporting for COVID-19 testing (PDF)
https://www.ama-assn.org/system/files/2020-03/cpt-reporting-covid-19-testing.pdf

Coding scenarios and how to apply best coding practices (PDF)
https://www.ama-assn.org/system/files/2020-03/covid-19-coding-advice.pdf

CPT® releases new coronavirus (COVID-19) code & description for testing
https://www.ama-assn.org/practice-management/cpt/cpt-releases-new-coronavirus-covid-19-code-description-testing

AMA Fact Sheet: Reporting Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2) Laboratory Testing
https://www.ama-assn.org/system/files/2020-03/cpt-assistant-guide-coronavirus.pdf

  • Manual upload of code descriptor into EHR.
  • CPT code 87635 will be part of the complete CPT code set in the data file for 2021.
  • Microbiology subsection of the Pathology and Laboratory section.
  • Long code descriptor note: Code 87635 will be a child code under parent code 87471.
  • It is represented here as the full long descriptor including the language from parent code 87471.
  • If the claim is submitted to a payer that requires CPT codes, then code 87635 should be reported.
  • Conversely, if the payer requires use of the HCPCS Level II code, the HCPCS Level II code should be reported. CPT and HCPCS codes should not both be reported on the same claim.

CMS, Healthcare Common Procedure Coding System (HCPCS)

HCPCS is a standardized coding system that Medicare and other health insurers use to submit claims for services provided to patients.

Testing for SARS-CoV-2/2019-nCoV (COVID-19)

HCPCS U0001Tests at CDC testing laboratoriesHCPCS - U0001 - Billing coded for SARS-CoV-2/2019-nCoV (COVID-19)tests, specifically for CDC laboratories - Feb 13 2020
https://www.cms.gov/newsroom/press-releases/public-health-news-alert-cms-develops-new-code-coronavirus-lab-test
HCPCS U0002Tests at non-CDC laboratoriesHCPCS - U0002 - Billing coded for SARS-CoV-2/2019-nCoV (COVID-19) tests, specifically for Non-CDC laboratories - Mar 5 2020
https://www.cms.gov/newsroom/press-releases/cms-develops-additional-code-coronavirus-lab-tests

Coverage and Payment Related to COVID-19 Medicare

https://www.cms.gov/files/document/03052020-medicare-covid-19-fact-sheet.pdf

https://www.cms.gov/files/document/03092020-covid-19-faqs-508.pdf

  • Medicare claims processing will accept claims with U0001 and U0002 starting on Apr 1 2020, for dates of service on or after Feb 4 2020.
  • If the claim is submitted to a payer that requires CPT codes, then code 87635 should be reported. Conversely, if the payer requires use of the
    HCPCS Level II code, the HCPCS Level II code should be reported.
  • CPT and HCPCS codes should not both be reported on the same claim.

Quest Diagnostics' test is a molecular based assay which detects viral RNA in respiratory specimens.

Test Code:  39433

Test Name Short: Quest RT-PCR
Test Name Long: Quest Diagnostics’ SARS-CoV-2 RNA, Qualitative Real-Time RT-PCR

Learn More

Test Code 39433 - SARS-CoV-2 RNA, Qualitative Real-Time RT-PCR (polymerase chain reaction)
https://testdirectory.questdiagnostics.com/test/test-detail/39433/sars-cov-2-rna-qualitative-real-time-rt-pcr?q=39433&cc=MASTER

Our Response to Coronavirus Disease 2019 (COVID-19) 
http://www.questdiagnostics.com/home/Covid-19/

Fact Sheet for Healthcare Providers
http://www.questdiagnostics.com/dms/Documents/covid-19/SARSCoV-2_HCP_Fact_Sheet.pdf

Billing

CPT® releases new coronavirus (COVID-19) code & description for testing, effective Mar 13 2020: 87635
https://www.ama-assn.org/system/files/2020-03/cpt-assistant-guide-coronavirus.pdf
https://www.ama-assn.org/practice-management/cpt/cpt-releases-new-coronavirus-covid-19-code-description-testing

HCPCS - U0002 - Billing coded for SARS-CoV-2/2019-nCoV (COVID-19) tests, specifically for Non-CDC laboratories - Mar 5 2020
https://www.cms.gov/newsroom/press-releases/cms-develops-additional-code-coronavirus-lab-tests

LabCorp made its COVID-19 test available on Thursday, March 5, 2020.

Panel to Order: 139900

LabCorp 2019 Novel Coronavirus (COVID-19), NAA

Detection of SARS-CoV-2 to assist in the diagnosis of COVID-2019 infections.
Methodology: Nucleic Acid Amplification (NAA)
https://www.labcorp.com/tests/139900/2019-novel-coronavirus-covid-19-naa

Learn More

Q&A: LabCorp's Testing for COVID-19
https://www.labcorp.com/assets-media/2330

  • COVID-19 tests performed by LabCorp are qualitative assays using PCR technology (polymerase chain reaction)
  • Beginning Mon Mar 16 2020, LabCorp is performing the Roche test for COVID-19
  • Tests have the same test code, 139900

Sample Report, 139900
https://files.labcorp.com/testmenu-d8/sample_reports/139900.pdf

Information from LabCorp about Coronavirus Disease 2019 (COVID-19)
https://www.labcorp.com/information-labcorp-about-coronavirus-disease-2019-covid-19

  • LabCorp announced that it will be able to perform more than 20,000 COVID-19 tests per day beginning Friday, March 20, ahead of its original schedule.
  • LabCorp is now performing COVID-19 testing at its labs in Phoenix, Ariz., Burlington, N.C., and Raritan, N.J.

Billing

CPT® releases new coronavirus (COVID-19) code & description for testing, effective Mar 13 2020: 87635
https://www.ama-assn.org/system/files/2020-03/cpt-assistant-guide-coronavirus.pdf
https://www.ama-assn.org/practice-management/cpt/cpt-releases-new-coronavirus-covid-19-code-description-testing

HCPCS - U0002 - Billing coded for SARS-CoV-2/2019-nCoV (COVID-19) tests, specifically for Non-CDC laboratories - Mar 5 2020
https://www.cms.gov/newsroom/press-releases/cms-develops-additional-code-coronavirus-lab-tests

Great information on COVID-19 Labs from the Association of Public Health Laboratories (APHL)

https://www.aphl.org/programs/preparedness/Crisis-Management/COVID-19-Response/Pages/default.aspx

COVID-19 HL7 Data Messaging FAQs

Tested link on Mar 25 2020 and PDF no longer available; cannot locate.

https://www.aphl.org/programs/preparedness/Crisis-Management/Documents/03.03.2020_Updated_Informatics_FAQs_Guidance_(002).pdf

See bottom of Page 2/top of Page 3 for ORU_R01 COVID-19 sample messages (2.5.1 and 2.3.1) for four scenarios:

1) Inconclusive
2) Not Detected
3) SpmUnsat (specimen unsatisfactory)
4) Detected

Message segments are:

MSH | Message Header
PID | Patient Identification
ORC | Order Common
OBR | Observation Request
OBX | Observation Result
NTE | Note
SPM | Specimen

International Classification of Diseases, Tenth Revision (ICD-10)

Emergency ICD-10 diagnosis code of U07.1 assigned
to the disease diagnosis COVID-19.

Effective in USA as of 4/1/2020 - unprecedented off-cycle update

Emergency use ICD codes for COVID-19 disease outbreak
https://www.cdc.gov/nchs/icd/icd10cm.htm

New ICD-10-CM code for the 2019 Novel Coronavirus (COVID-19), April 1, 2020. Effective: March 18, 2020
https://www.cdc.gov/nchs/data/icd/Announcement-New-ICD-code-for-coronavirus-3-18-2020.pdf

An updated ICD-10 MS-DRG GROUPER software package to accommodate the new ICD-10-CM diagnosis code, U07.1, COVID-19, replaces the GROUPER software package V37.1.

https://edit.cms.gov/files/document/icd-10-ms-drgs-version-371-r1-effective-april-1-2020-updated-march-23-2020.pdf


ICD-10 COVID-19 Codes

Table created from coding guidance 2/20/2020:  https://www.cdc.gov/nchs/data/icd/ICD-10-CM-Official-Coding-Gudance-Interim-Advice-coronavirus-feb-20-2020.pdf

ICD-10 Code

Diagnosis COVID-19

Description

B97.29

Confirmed COVID-19

Other coronavirus as the cause of diseases classified elsewhere

B97.29 + J12.89

Pneumonia

Other viral pneumonia

B97.29 + J20.8

Acute Bronchitis

Acute bronchitis due to other specified organisms

B97.29 + J40

Bronchitis

Bronchitis, not specified as acute or chronic

B97.29 + J22

Acute Lower Respiratory Infection

Unspecified acute lower respiratory infection

B97.29 + J98.9

Lower Respiratory Infection

Respiratory disorder, unspecified

B97.29 + J80

ARDS

Acute respiratory distress syndrome

Code

Exposure COVID-19

Description

Z03.818

Exposure Concern Ruled Out

Encounter for observation for suspected exposure to other biological agents ruled out

Z20.828

Exposure Actual

Contact with and (suspected) exposure to other viral communicable diseases

Code

Signs and Symptoms

Description

R05

Cough

Cough

R06.02

Shortness of breath

Shortness of breath

R50.9

Fever, unspecified

Fever, unspecified

Code

Do Not Assign

Description

B97.29 - Do Not Use for >

DO NOT USE for Suspected, Possible, Probable COVID-19

USE only for Confirmed COVID-19

Other coronavirus as the cause of diseases classified elsewhere

B34.2

Coronavirus infection, unspecified

Generally not appropriate for COVID-19