National coding practices & tips for the COVID-19 pandemic

National coding practices & tips for the COVID-19 pandemic

Submitted by the National Coding Secretariat Group

We are in the midst of unprecedented times as a result of the COVID-19 pandemic, which impacts all of us both personally and professionally. Across the country, there are strategies and efforts underway to ensure the safety of our staff, our families, and ourselves. This is an opportunity to support and stay connected to one another.   

Coding members are continuing to maintain business continuity and are working hard to manage the safety of their teams. Coders are being asked to meet the fast-approaching, year-end deadline with CIHI. At this same time, their workload has increased, and many coders are being asked to support other areas at a hospital (e.g., assisting with screening or covering staff absences due to COVID-19). During this challenging time, remote coding teams appear to be less affected by these stressors, as long as systems remain stable, while on-site teams are experiencing some of these more unique challenges.   

Below are some tips and current practices being used to keep staff safe and manage the coding challenges being experienced during this crisis. 

Ensure CIHI reporting is accurate and consistent

Current practice: COVID cases are to be coded as ‘confirmed’ (U07.1) and ‘suspected’ (U07.2). Please see the latest CIHI memo, dated March 26, 2020.

Educate coding teams

Tip: CIHI encourages coding teams to place ‘suspected’ COVID charts on hold for to a final review. When final Public Health Agency of Canada (Public Health) results are received back, then code accordingly.

Help to ensure that final COVID test results are updated in the health record.

Current practice: Outpatient visits are discharged and Public Health results are being released afterwards.

Tip: Encourage clinical and infection control teams at all hospitals to update documentation when test results are received back from Public Health, even if the patient has been discharged. This will help to ensure accurate and consistent reporting to CIHI.

Encourage additional targeted education for clinical teams with EMRs

Tip: Many EMRs have ICD-10-CA search engines to assist clinicians with documentation, and the search tools are not always intuitive to meet CIHI requirements. We encourage coding teams to:

a)     Work with your EMR developers to add an intuitive descriptor in the search engine to assist clinicians in searching for ‘suspected COVID’ codes

b)     Assist with educating clinicians on how to use these tools to accurately search/document ‘confirmed’ (U07.1) and ‘suspected’ (U07.2) COVID cases

Ensure staff safety

Tips: Support working from home whenever possible and as technology allows. Allow staff to work evenings and weekends and/or utilize alternative workspace to enable physical distancing practices. Promote hand hygiene practices and sneezing/coughing etiquette as advised by Public Health and Infection Prevention and Control Canada.

If you would like to share your experiences with the National Coding Secretariat Group (e.g., things that are working well or lessons learned) please reach out to [email protected] The National Coding Secretariat Group reports to the National Coding Committee.

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