Emerging Medical Trends in Response to COVID-19

New medical trends are emerging as preparations are underway for the incoming financial, organizational, and human burden that will be thrust upon hospitals and medical facilities across the nation due to the spread of the Novel Coronavirus and its corresponding disease (COVID-19). Health services worldwide are taking exceptional measures in order to better adapt to the pandemic. With certain problematic developments unfolding in foreign contexts determined to be ahead of the US in the timeline of coronavirus transmission, administrative officials in domestic medical facilities are undertaking efforts to shore up perceived shortcomings at local and regional levels. As such, there has been a shift in emphasis from non-urgent medical interventions (i.e. elective procedures for aesthetic or functional purposes) to testing and the bolstering of intensive care capabilities. The call of the medical profession in its response to the coming health crisis appears to be unequivocal: “All hands on deck!”

The healthcare system will begin – and in part already has begun – to brace for impact with the reallocation of resources and rerouting of efforts to meet the current and burgeoning need. Refer to our previous article, “How the Coronavirus Will Impact the Availability of Resources in Medical Facilities,” for a preliminary assessment of how the medical supply chain will be affected by the outbreak of COVID-19. This organizational, as well as staff- and resource-oriented, change comes at a real price and demands responsible, attentive action in order to have a chance of attaining a successful end.

Importantly, medical facilities have begun to delay less complicated, low-risk procedures with surety of compensation in favor of COVID-19 cases associated with heightened urgency but also intrinsic complexity and risk. The shift from “high-margin” procedures to the expensive and precarious handling of coronavirus patients is accompanied by a number of issues, the cost of which can already be felt, though not yet fully quantified.

Intensive care units are being afforded extra beds and stocked with remaining supplies, as reports from other countries show that providing extensive access to ICU services will prove a determining factor in the management of potentially fatal cases.

Medical facilities are also proactively combatting a perceived staffing crisis at all levels, ranging from nurses to doctors and all manner of specialists and experts. Varieties of competent workers are being summoned and sent to the front lines in order to brace for the inevitable extent of incoming new and prospective patients.

In a broad sense, the importance of the collective channeling of energy and resources in the effort to identify, process, and treat COVID-19 patients cannot be overstated. The long-term effectiveness of the healthcare response to COVID-19 will be predicated on a few factors; namely, ample supply lines, robust mobilization of competent workers, on-site preparedness and organization, and the undistorted flow of information, which is conditioned by the wide availability of proper testing and managing of patient information. It is incumbent upon all healthcare professionals to do their part as confirmed cases become more prevalent. Screening, testing, processing, and treatment are each characterized by their own spheres of responsibility and competence. All levels of medical action will bear equal weight in the combined response to the COVID-19 crisis.

The proper flow of information begins with testing. Though the scarcity of material resources (ventilators, masks, etc.) and competent staff are also cause for concern, it is no less important that efforts be devoted to the testing and processing of new and prospective patients. Since tests are limited, proper screening on the part of processing staff is also consequential.

Administrators and medical specialists alike will be called upon to contribute to the extraordinary effort required to face the challenge posed by COVID-19. By the same token, the exceptional circumstances of a pandemic demand attentive and responsible action on the part of medical coding professionals. The increase in case frequency will necessitate enhanced numbers of specific coding tasks. Attentiveness to precise classifications and distinctions will aid in the proper transfer of information. A recent supplement issued by the CDC on February 20 regarding the “coding of encounters related to coronavirus” details the most important official coding assignments related to COVID-19 diagnosis (CDC, 2020). Our previous article, “Coding for Coronavirus Outbreak: Interim Guidance from the CDC,” explores the evolution of COVID-19, as well as explains the official coding guidelines laid out by the CDC.

In particular, three salient points can be gathered from the document:

1. Precise codes for illness caused by COVID-19 include those for Pneumonia, Acute Bronchitis, Lower Respiratory Infection, and Acute Respiratory Distress Syndrome (ARDS) (see document, p. 1-2).
2. In the instance of non-confirmed cases involving patients who exhibit related signs and symptoms, coders are to assign the appropriate code(s) for each of the signs and symptoms (e.g. for cough, fever, etc.) and specifically not to assign the code B97.29, even if “suspected,” “possible,” or “probable” COVID-19 is documented.
3. Additional codes may be required to fully document various scenarios in accordance with the official ICD-10-CM guidelines.