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Now is the time to start building your COVID-19 queries

Senior Consultant, Freedman HealthCare, LLC

Mary Jo Condon, MPPA, sees information and collaboration as the foundation for improving our nation’s healthcare system.

For many all payer claims databases (APCDs), data for the first quarter of 2020 will be available this summer. With this in mind, now is a good time to begin developing queries to identify COVID-19 cases and utilization.  Developing these queries now can offer analysts a few weeks to build the queries, test them and analyze trends over the last several years to understand normal year to year variation. More information on how to design these queries can be found in our recent blog post, “How to find coronavirus in your APCD.”

Understanding “typical” utilization for cases of pneumonia, fever and other diagnoses related to COVID-19 will be particularly important for two reasons:

  • Recent data from the Centers for Disease Control and Prevention finds total deaths in several states are much higher than normal and the difference is considerably higher than the numbers of deaths officially attributed to COVID-19. The new data is partial but suggests the disease is probably killing more people than the reported public health statistics capture. By combining utilization data for the early weeks of the virus with a solid understanding of historical utilization trends, ACPDs can support a better understanding of the true impact of COVID-19.
  • The code specific to COVID-19, U07.1, was effective April 1, 2020 as a revision of ICD-10-CM.

For COVID related care prior to April 1, the CDC recommended using B97.29, Other coronavirus as the cause of diseases classified elsewhere in conjunction with the code for the reason for the encounter (e.g. pneumonia, acute bronchitis). The CDC recommended only using the additional B97.29 code for confirmed cases of COVID-19. Suspected, possible or probable cases of COVID-19 are to be reported only with codes explaining the reason for the encounter. Given this guidance and limited testing capacity, a thorough review of related diagnoses will be necessary.

If you have a question or would like help building your queries, contact Mary Jo Condon at mcondon@freedmanhealthcare.com.

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