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How to classify COVID-19

The Independent Health and Aged Care Pricing Authority (IHACPA) provides guidance for classifying coronavirus disease 2019 (COVID-19) related activity across the admitted care, emergency department care and non-admitted care settings.

In March 2020, IHACPA published the Rules for coding and reporting COVID-19 episodes of care to implement measures under the National Partnership on COVID-19 Response, that was recently extended to 31 December 2022.

IHACPA has updated the guidance on how to classify COVID-19 effective 1 July 2022 which supersedes information outlined in the previous Rules for coding and reporting COVID-19 episodes of care.

How to classify COVID-19 from 1 July 2022

Admitted care

A new Australian Coding Standard (ACS 0113 Coronavirus disease 2019 (COVID-19)) has been developed for Twelfth Edition providing guidance on how to classify COVID-19 in admitted episodes and supersedes all previous advice related to COVID-19.

Emergency department care

The Emergency Department ICD-10-AM Principal Diagnosis Short List (ED Short List) was updated in 2022 with additional codes to classify COVID-19 testing and adverse reactions to the COVID-19 vaccine. Additional information on the reporting rules for COVID-19 for emergency department care can be found below:

Non-admitted care

There have been no changes to the reporting of COVID-19 activity in the non-admitted care setting. Information on the classification rules for COVID-19 in the non-admitted care setting can be found below:

How to classify COVID-19 prior to 1 July 2022

Please note advice displayed in this section is no longer in effect. For current COVID-19 classification and coding advice, please refer to information located above, ‘How to classify COVID-19 from 1 July 2022’.

On 13 March 2020, the Commonwealth and all state and territory governments signed the National Partnership on COVID-19 Response to provide financial assistance for the additional costs incurred by health services in responding to the COVID-19 outbreak.

Rules for coding and reporting

IHACPA issued classification advice to specify the rules for coding and reporting of COVID-19 in Australian hospitals in admitted, emergency department and non-admitted care from March 2020. Previous advice can be found in the Rules for coding and reporting COVID-19 episodes of care.

Admitted care

In addition to the Rules for coding and reporting COVID-19 episodes of care, supplementary advice and frequently asked questions (FAQs) were issued to support the classification of COVID-19 in admitted care:

•    How to classify COVID-19 – Supplementary guidance and FAQs for classifying admitted care in Eleventh Edition

Please be aware that the guidance published in How to classify COVID-19 - Supplementary guidance and FAQs for classifying admitted care in Eleventh Edition has been superseded by the publication of ICD-10-AM/ACHI/ACS Twelfth Edition.

Emergency department care

In addition to the Rules for coding and reporting publication, FAQs were issued to support the classification of COVID-19 in emergency department care:

•    Emergency department care FAQs – Part 1 (Published 25 May 2020)

•    Emergency department care FAQs – Part 2 (Published 17 September 2020)

Queries about classifying COVID-19 in emergency department care should be followed up with jurisdictional health authorities.

Non-admitted care

Queries about classifying COVID-19 in non-admitted care should be followed up with jurisdictional health authorities.

Data Set Specifications

The reporting of COVID-19 data was endorsed for inclusion in the 2019–20, 2020–21, 2021–22 and 2022–23 data request specifications.

List of updates

The following list summarises updates to the guidance provided on this page.

Update Section(s) Description Status
1 July 2022 Admitted care, Emergency department care and Non-admitted care Updated classification and coding advice Active
1 July 2022 Emergency department care Implementation of new COVID-19 codes Active
20 August 2021 Frequently asked questions – Admitted care Publishing of admitted care FAQs – Part 4 – (published 20 August 2021) Superseded 1 July 2022
10 March 2021 Non-admitted care Incorporating new class 10.21 COVID-19 vaccination and related counting rules (Version 2.0) Active
18 December 2020 Supplementary guidance for classifying admitted care Publishing of Coding Rules – Post COVID-19 conditions (effective 1 January 2021) Superseded 1 July 2022
17 September 2020 Frequently asked questions – Admitted care Publishing of admitted care FAQs – Part 3 (Published 17 September 2020) Superseded 1 July 2022
17 September 169162020 Frequently asked questions – Emergency department care Publishing of emergency department care FAQs – Part 2 (published 17 September 2020) Superseded 1 July 2022
25 May 2020 Frequently asked questions – Admitted care Publishing of admitted care FAQs – Part 2 (published 25 May 2020) Superseded 1 July 2022
25 May 2020 Frequently asked questions – Emergency department care Publishing of emergency department care FAQs – Part 1 (published 25 May 2020) Superseded 1 July 2022
1 May 2020 Frequently asked questions – Admitted care Publishing of admitted care FAQs – Part 1 (published 1 May 2020) Superseded 1 July 2022
1 May 2020   Publishing of 'Rules for coding and reporting COVID-19 episodes of care' (Version 1.1) Superseded 1 July 2022
9 April 2020 Additional notes for all cases
 
Updated Note 3 for new instructional notes included in ICD-10 2019 for U07.2 Emergency use of U07.2 [COVID-19, virus not identified] Superseded 1 July 2022
9 April 2020 Supplementary guidance/Rules out cases Removed redundant category ‘Pregnancy complicated by COVID-19 or other condition’ in Ruled out cases
Adapted wording under Key points related to ACS 0012 Suspected conditions
Superseded 1 July 2022
9 April 2020 Supplementary guidance/Laboratory confirmed cases
Supplementary guidance/Clinically diagnosed or probable cases
Supplementary guidance/Ruled out cases
Wording added “as per ACS 0001 Principal diagnosis” to align with text in Coding Rule Superseded 1 July 2022
3 April 2020   Publishing of 'Rules for coding and reporting COVID-19 episodes of care' (Version 1.0) Superseded 1 July 2022

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