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ICD-10-CM Guidelines: Updates Effective January 1, 2021

The pandemic has reshaped much of the world, including healthcare compliance training, and the medical community has needed to adapt to the challenge. One specific way that the healthcare industry has been impacted is that the CDC has updated its ICD-10-CM coding guidelines to account for the unique ways COVID-19 affects the body.

As of January 1, 2021, CDC guidelines have introduced new coding criteria to help identify and treat patients who may be diagnosed with COVID-19. Keep reading to learn more about the updated guidance.Why the Change?

The changes to the ICD-10-CM guidelines are designed to account for the unique circumstances brought about due to the pandemic. While many who have been working in the healthcare field for a significant time may understand the importance of proper coding, it’s worth noting that being aware of these changes can improve contact tracing, reporting, and policymaking surrounding the healthcare industry to help deal with public health challenges.

The recent guideline update is designed to track and manage COVID-19 cases, which can manifest in various ways and therefore has required new guidance on how to track COVID-19 patients.
What’s Changed?

The new guidelines are designed to address COVID-19 infections in the general population. New guidance has also been issued for COVID-19 cases in women who are pregnant and newborns.

There have been multiple changes to the coding structure, but broadly they deal with conditions like:

  • Pneumonia
  • Acute Bronchitis
  • Lower Respiratory Infection
  • Acute Respiratory Distress Syndrome

There’s also been updated guidance regarding the coding of symptoms related to COVID-19, such as cough, shortness of breath, and unspecified fevers.What Else Should Be Considered?

These changes are designed to deal with cases that are both confirmed and suspected COVID-19 cases. The new guidance provides criteria for how to code instances where a positive test has not yet been received, but the medical team believes the patient might have COVID-19 or is otherwise unable to identify another underlying cause of the condition.

To find out more about the updated ICD-10-CM guidelines from the CDC, or discuss healthcare and medical eLearning solutions, contact the MedTrainer team today!