Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Oct 3;5(10):e2235089.
doi: 10.1001/jamanetworkopen.2022.35089.

Use of the Postacute Sequelae of COVID-19 Diagnosis Code in Routine Clinical Practice in the US

Leah J McGrath  1 , Amie M Scott  1 , Andy Surinach  2 , Richard Chambers  3 , Michael Benigno  1 , Deepa Malhotra  1
Affiliations

Use of the Postacute Sequelae of COVID-19 Diagnosis Code in Routine Clinical Practice in the US

Leah J McGrath et al. JAMA Netw Open. .

Abstract

Importance: A new International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) diagnosis code (U09.9 Post COVID-19 condition, unspecified) was introduced by the Centers for Disease Control and Prevention on October 1, 2021.

Objective: To examine the use of the U09.9 code and describe concurrently diagnosed conditions to understand physician use of this code in clinical practice.

Design, setting, and participants: This cohort study of US patients with an ICD-10-CM code for post-COVID-19 condition used deidentified patient-level claims data aggregated by HealthVerity. Children and adolescents (aged 0-17 years) and adults (aged 18-64 and ≥65 years) with a post-COVID-19 condition code were identified between October 1, 2021, and January 31, 2022. To identify a prior COVID-19 diagnosis, 3 months of continuous enrollment (CE) before the post-COVID-19 diagnosis date was required.

Main outcomes and measures: Presence of the ICD-10-CM U09.9 code.

Results: There were 56 143 patients (7723 female patients [61.2%]; mean [SD] age, 47.6 [19.2] years) with a post-COVID-19 diagnosis code, with cases increasing in mid-December 2021 following the trajectory of the Omicron case wave by 3 to 4 weeks. The analysis cohort included 12 622 patients after the 3-month preindex CE criteria was applied. Among this cohort, the median (IQR) age was 49 (35-61) years; however, 1080 (8.6%) were pediatric patients. The U09.9 code was used most often in the outpatient setting, although 305 older adults (14.0%) were inpatients. Only 698 patients (5.5%) had at least 1 of the 5 codes listed as possible concurrent conditions in the coding guidance. Only 8879 patients (70.4%) had a documented acute COVID-19 diagnosis code (569 [52.7%] among children), and the median (IQR) time between acute COVID-19 and post-COVID-19 diagnosis codes was 56 (21-200) days. The most common concurrently coded conditions varied by age; children experienced COVID-19-like symptoms (eg, 207 [19.2%] had cough and 115 [10.6%] had breathing abnormalities), while 459 older adults aged 65 years or older (21.1%) experienced respiratory failure and 189 (8.7%) experienced viral pneumonia.

Conclusions and relevance: This retrospective cohort study found patients with a post-COVID-19 ICD-10-CM diagnosis code following the acute phase of COVID-19 disease among patients of all ages in clinical practice in the US. The use of the U09.9 code encompassed a wide range of conditions. It will be important to monitor how the use of this code changes as the pandemic continues to evolve.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest Disclosures: Dr McGrath reported being employed by and holding stock in Pfizer, Inc. Ms Scott reported being employed by and holding stock and stock options in Pfizer, Inc. Mr Surinach reported receiving consulting fees from Pfizer, Inc. Mr Chambers being employed by Pfizer, Inc. Mr Benigno reported being employed by and owning stock in Pfizer, Inc. Ms Malhotra reported being employed by and holding stock in Pfizer, Inc. No other disclosures were reported.

Figures

Figure 1.
Figure 1.. Weekly Number of Post–COVID-19 Diagnosis Codes and COVID-19 Diagnosis Codes, October 1, 2021, to January 28, 2022 (Open and Closed Claims)
Light blue indicates COVID-19 diagnosis codes and dark blue indicates post–COVID-19 diagnosis codes.
Figure 2.
Figure 2.. Observed Proportions of Concurrent Diagnosis Codes on the Day of Post–COVID-19 Diagnosis Code by Age
COPD indicates chronic obstructive pulmonary disease; GERD, gastroesophageal reflux disease.
Figure 3.
Figure 3.. Observed Proportion of Diagnosis Codes on the Day of the Post–COVID-19 Diagnosis Code vs in the 30 Days Before the Post–COVID-19 Diagnosis Code
COPD indicates chronic obstructive pulmonary disease; GERD, gastroesophageal reflux disease.
See this image and copyright information in PMC

References

    1. Bellan M, Soddu D, Balbo P, Baricich A, Zeppegno P, Avanzi G. Respiratory and psychophysical sequelae among patients with COVID-19 four months after hospital discharge. JAMA Netw Open. 2021;4(1):e2036142. doi:10.1001/jamanetworkopen.2020.36142 - DOI - PMC - PubMed
    1. Crook H, Raza S, Nowell J, Young M, Edison P.. Long covid—mechanisms, risk factors, and management. BMJ. 2021;374:n1648. doi:10.1136/bmj.n1648 - DOI - PubMed
    1. Tabacof L, Tosto-Mancuso J, Wood J, et al. . Post-acute COVID-19 syndrome negatively impacts health and wellbeing despite less severe acute infection. MedRxiv. Preprint posted online November 6, 2020. doi:10.1101/2020.11.04.20226126 - DOI
    1. Nalbandian A, Sehgal K, Gupta A, et al. . Post-acute COVID-19 syndrome. Nat Med. 2021;27(4):601-615. doi:10.1038/s41591-021-01283-z - DOI - PMC - PubMed
    1. Centers for Disease Control and Prevention . New ICD-10-CM code for post-COVID conditions, following the 2019 novel coronavirus (COVID-19). Accessed September 1, 2022. https://www.cdc.gov/nchs/data/icd/announcement-new-icd-code-for-post-cov...

Publication types