Real World Evidence Center of Excellence, Pfizer Inc, New York, New York.
Genesis Research, Hoboken, New Jersey.
JAMA Netw Open. 2022 Oct 3;5(10):e2235089. doi: 10.1001/jamanetworkopen.2022.35089.
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.
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.
Presence of the ICD-10-CM U09.9 code.
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.
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.
美国疾病控制与预防中心于 2021 年 10 月 1 日引入了新的国际疾病分类，第十次修订版，临床修正（ICD-10-CM）诊断代码（U09.9 新冠后状况，未特指）。
检查 U09.9 代码的使用情况，并描述同时诊断的疾病，以了解医生在临床实践中使用该代码的情况。
设计、设置和参与者：本研究对美国患有新冠后状况 ICD-10-CM 代码的患者进行了队列研究，使用了 HealthVerity 汇总的匿名患者级别的索赔数据。儿童和青少年（0-17 岁）和成年人（18-64 岁和≥65 岁）在 2021 年 10 月 1 日至 2022 年 1 月 31 日期间有新冠后状况代码。为了确定之前的 COVID-19 诊断，需要在新冠后诊断日期前连续 3 个月（CE）的入组。
存在 ICD-10-CM U09.9 代码。
有 56143 名（7723 名女性患者[61.2%]；平均[标准差]年龄，47.6[19.2]岁）患有新冠后诊断代码的患者，在奥密克戎病例波的 3 到 4 周后，12 月中旬病例数量增加。在应用 3 个月的预指数 CE 标准后，分析队列纳入了 12622 名患者。在该队列中，中位数（IQR）年龄为 49（35-61）岁；然而，有 1080 名（8.6%）为儿科患者。U09.9 代码主要在门诊环境中使用，尽管有 305 名老年人（14.0%）为住院患者。只有 698 名患者（5.5%）至少有编码指南中列出的 5 个可能并发疾病中的 1 个。只有 8879 名患者（70.4%）有记录的急性 COVID-19 诊断代码（儿童中有 569 名[52.7%]），急性 COVID-19 和新冠后诊断代码之间的中位（IQR）时间为 56（21-200）天。同时编码的最常见疾病因年龄而异；儿童经历 COVID-19 样症状（例如，207 名[19.2%]有咳嗽，115 名[10.6%]有呼吸异常），而 459 名 65 岁或以上的老年人（21.1%）经历呼吸衰竭，189 名（8.7%）经历病毒性肺炎。
这项回顾性队列研究发现，在美国的临床实践中，所有年龄段的患者在 COVID-19 疾病的急性期后都有新冠后 ICD-10-CM 诊断代码。U09.9 代码的使用涵盖了广泛的疾病。随着大流行的继续演变，监测该代码的使用变化将很重要。
