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NCCQ March 2022 > Chapter XXII Codes for Special Purposes (and COVID-19 Guidance) > Flashcards

Chapter XXII Codes for Special Purposes (and COVID-19 Guidance) Flashcards

1
Q

How must the statement of MRSA be coded?

A

U82.1 Resistance to methicillin must be assigned immediately after the code which identifies that the infective agent is staphylococcus aureus

DCS XXII.2

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2
Q

Code U85.X identifies a specific type of resistance. How is it used?

A

Category U85.X must only be used to identify resistance, non-responsiveness and refractive properties of a neoplasm or other condition to antineoplastic drugs

DCS XXII.2

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3
Q

How must non-infectious conditions classified outside of Chapter XVIII Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified, that are documented as being due to or caused by COVID-19 be coded?

A

Codes for any condition (including non-infectious conditions) classified outside of Chapter XVIII Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified, that are documented as being due to or caused by COVID-19, must be assigned after U07.1. Each code must be followed by B97.2 excluding codes from Chapter I

COVID-19 NCCS 11.21

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4
Q

When must the code U07.3 Emergency use of U07.3 [Personal history of COVID-19] NOT be assigned?

A

U07.3 must not be assigned on episodes where patients are being treated for an acute COVID-19 infection (U07.1 Emergency use of U07.1 [COVID-19, virus identified] or U07.2 Emergency use of U07.2 [COVID-19, virus not identified]) or a post COVID-19 condition (U07.4 Emergency use of U07.4 [Post COVID-19 condition])

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5
Q

If more than 1 condition is identified as post-COVID-19 condition, where must the code U07.4 be assigned

  • after all conditions listed
  • after each condition listed
  • before all conditions listed
A

Where multiple conditions or symptoms are described as post COVID-19, U07.4 must be assigned directly after each of the codes that classify the conditions or symptoms.

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6
Q

Whenever coronavirus is documented in the medical record as a laboratory identified virus causing a disease classified to a body system chapter, both codes U07.1 and B97.2 must be used in the coding summary. Is this statement true or false?

A

False. Emergency code U07.1 must only be used when COVID-19 virus has been identified.

(NB: coronavirus has first been identified as a causative agent for respiratory disorders in 1930-s)

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7
Q

In cases of multi-drug resistance, when is it permissible not to use individual four-character codes within categories U82.-, U83.- or U84.- and use codes U83.7 Resistance to multiple antibiotics or U84.7 Resistance to multiple antimicrobial drugs instead? (2 cases)

A
  • An agent is resistant to two or more antibiotic/antimicrobial drugs each classifiable to U83.8 Resistance to other single specified antibiotic or U84.8 Resistance to other specified antimicrobial drug.
  • An agent is resistant to two or more antibiotic/antimicrobial drugs where the antibiotic/antimicrobial drugs are not specified.

DCS XXII.2

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8
Q

What are the 3 condition for the use of categories U82-U85? (Hint: 2 of the conditions are related to sequencing)

A
  • Never be used as primary diagnosis codes
  • Only be used in a secondary position, sequenced directly following the code they enhance
  • Only be assigned when drug resistance is clearly documented in the medical record by the responsible consultant.

DCS XXII.2

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9
Q

Which documentation must be used when extracting information about resistance?

A

Resistance codes must be used when this information is clearly documented within the patient’s medical record. The coder must never interpret laboratory results in order to identify the antibiotic/antimicrobial drug to which an agent is resistant

DCS XXII.2

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10
Q

Can the code B97.2 be assigned with codes from codes from Chapter XV Pregnancy, childbirth and the puerperium to identify that a symptom of COVID-19 is complicating labour or delivery, considering it is not a body system chapter?

A

B97.2 may be assigned with codes from Chapter XV Pregnancy, childbirth and the puerperium to identify that a symptom of COVID-19 is complicating labour or delivery

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11
Q

If confirmed or probable COVID-19 infection is not the main condition treated, what are the rules of sequencing codes U07.1 and U07.2?

A

The main condition treated or investigated is unrelated to COVID-19 must be sequenced first (DGCS.1: Primary diagnosis must be applied). Where U07.1 or U07.2 does not appear in the primary diagnosis field, it must be sequenced directly after the code for the primary diagnosis, except where another standard prevents this.

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12
Q

If COVID-19 infection was initially suspected, but subsequently ruled out by a negative result, how should this scenario be coded?

A
  1. Code for the relevant stated conditions or symptoms
  2. Z03.8 Observation for other suspected diseases and conditions
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13
Q

Where must the code U07.5 Emergency use of U07.5 [Multisystem inflammatory syndrome associated with COVID-19] be assigned in relation to U07.1 and U07.2, if a patient is concurrently diagnosed with an acute COVID-19 infection?

A

Where a patient is also documented as having an acute COVID-19 infection (confirmed or suspected), U07.5 must be assigned directly after U07.1 or U07.2.

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14
Q

Are the codes B34.2 Coronavirus infection, unspecified site and U07.1 Emergency use of U07.1 [COVID-19, virus identified] interchangeable?

A

No, B34.2 Coronavirus infection, unspecified site must not be assigned to classify COVID-19.

COVID-19 NCCS 11/21

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15
Q

What are the acceptable formulations of a suspected COVID-19 infection, which enable the U07.2 code assignment?

A

U07.2 includes cases of suspected, probable, and presumed COVID-19, or patients being treated as having COVID-19 in the absence of a positive laboratory test where COVID-19 has not been ruled out.

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16
Q

Does the code U07.5 Emergency use of U07.5 [Multisystem inflammatory syndrome associated with COVID-19] include all the complications that it causes, or do they need to be identified separately?

A

Where multisystem inflammatory syndrome associated with COVID-19 leads to complications (e.g. acute kidney injury (AKI), myocarditis), codes for these complications must be assigned following U07.5. It is not necessary to assign codes from Chapter XVIII unless the symptom is treated as a problem in its own right.

17
Q

When only ‘vaping related disorder’ is documeted, but the disorder is not known, code from which chapter must be used:

  • CHAPTER XXII CODES FOR SPECIAL PURPOSES or
  • CHAPTER XVIII SYMPTOMS, SIGNS AND ABNORMAL CLINICAL AND LABORATORY FINDINGS, NOT ELSEWHERE CLASSIFIED
A

Where only ‘vaping related disorder’ is documented then U07.0 may be used alone.

DCS XXII.4

18
Q

If COVID-19 infection is documented to be hospital acquired, where must the code Y95.X Nosocomial condition be recorded?

A

Where COVID-19 is documented as hospital acquired, Y95.X Nosocomial condition must be assigned directly after U07.1 or U07.2. Y95.X must also be assigned after each code for any other conditions that have been documented as hospital acquired.

19
Q

What other terms can be used to describe ‘vaping related disorder’?

A

E-Cigarette or Vaping Associated Lung Injury (EVALI), dabbing related lung damage, dabbing related disorder, electronic cigarette related lung damage, and electronic cigarette related disorder.

(DCSXXII.4 Guidance note)

20
Q

Which U07 category is used, when COVID-19 laboratory result is inconclusive, but the responsible consultant confirms COVID-19 infection?

A

U07.2 Emergency use of U07.2 [COVID-19, virus not identified] must be assigned when laboratory testing for COVID-19 is reported as inconclusive, or has not been carried out, but the responsible consultant confirms a diagnosis of COVID-19 based on clinical or epidemiological evidence.

21
Q

Which code in U07 category is NOT related to COVID-19?

A

Vaping related disorder (U07.0)

DCS XX.4

22
Q

How should asymptomatic laboratory confirmed COVID-19 infection be coded?

A

U07.1 is assigned without additional codes in cases of laboratory confirmed COVID-19 where patients are asymptomatic.

COVID-19 NCCS 11.21

23
Q

How should instances, where COVID-19 is not ruled out by a negative result be coded? when the responsible consultant continues to suspect COVID-19?

A

U07.2 Emergency use of U07.2 [COVID-19, virus not identified] must be assigned

24
Q

When an agent is resistant to two or more antibiotic/antimicrobial drugs, code U83.7 Resistance to multiple antibiotics or U84.7 Resistance to multiple antimicrobial drugs must be used to observe the principle of Totality of codes. Is this statement True or False?

A

False. When an agent is resistant to two or more antibiotic/antimicrobial drugs classifiable to individual four-character codes within categories U82.-, U83.- or U84.-, a code for each drug the agent is resistant to must be assigned.

25
Q

When a vaping-related disorder as been identified, which Chapter XX external cause code should be used?

A

An external cause code from Chapter XX is not required as the substance or substance combination leading to the lung damage has not yet been identified.

(DCS XXII.4 example note)

26
Q

Must the code U07.7 Emergency use of U07.7 [COVID-19 vaccines causing adverse effects in therapeutic use] be used in the same way as other adverse effect codes, or does it have separate rules?

A

In the same way, must be assigned in accordance with DCS.XX.7: Drugs, medicaments and biological substances causing adverse effects in therapeutic use (Y40-Y59)

27
Q

When it is clearly documented, that a respiratory condition has resulted from vaping or the use of e-cigarettes, which code combination must be used?

A

U07.0 Emergency use of U07.0

J68.- Respiratory conditions due to inhalation of chemicals, gases, fumes and vapours

DCS XXII.4

28
Q

If a patient is treated as having COVID-19 pneumonia in the absence of a positive laboratory test where COVID-19 has not been ruled out, is the code B97.2 required following the code for pneumonia?

A

(B97.2 must not be assigned in addition to any codes for conditions or symptoms attributed to suspected COVID-19 (U07.2) as coronavirus has not been definitively identified

29
Q

If a patient, who is clinically diagnosed with COVID-19 in the absence of a confirmed positive laboratory test, is documented to have confirmed or suspected exposure to COVID-19, how should it be captured?

A

By code Z20.8 Contact with and exposure to other communicable diseases assigned directly after U07.2 Emergency use of U07.2 [COVID-19, virus not identified]

30
Q

When the responsible consultant clearly documents in the patient’s medical record that coronavirus has been identified as the cause of SARS, which code combination must be assigned?

A

U04.9 Severe acute respiratory syndrome [SARS], unspecified
B97.2 Coronavirus as the cause of diseases classified to other chapters
DCS XXII.1

31
Q

In which circumstances must codes from categories U06 and U07 be used?

A

Categories U06 and U07 must only be used when specifically instructed by the Terminology and Classifications
Delivery Service under direction from the WHO.

DCS XXII.3

32
Q

Where symptoms due to COVID-19 have been identified and no condition classified outside of Chapter XVIII is diagnosed, what should be assigned following U07.1 Emergency use of U07.1 [COVID-19, virus identified], if at all?

A

Codes from Chapter XVIII, B97.2 must not be assigned directly after Chapter XVIII symptom codes.

COVID-19 NCCS 11.21

33
Q

Is it permissible to use the code U07.4 Emergency use of U07.4 [Post COVID-19 condition] on its own?

A

Where the only information available is ‘Post COVID-19 condition’ or ‘Post COVID-19 syndrome’, U07.4 may be assigned alone.

34
Q

Status of current vaping/ e-cigarette use has a devoted code U07.0. Is this statement True or False?

A

False. Code U07.0 must not be used to classify the use of a vaping device or e-cigarette.

DCS XXII.4

35
Q

If a respiratory condition that resulted from vaping or the use of E-cigarettes has a devoted code not classified to category J68, must J68 be assigned in preference to a code classified elsewhere?

A

Where the condition(s) caused by vaping or the use of e-cigarettes is classified elsewhere then the appropriate code(s) to describe that condition must be used instead of J68.-

DCS XXII.4

NCCQ March 2022 (8 decks)

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