March 2020 SNOMED-CT Update Adds COVID-19 Diagnosis and More

On March 19, 2020, PCC updated the SNOMED-CT diagnostic terms on your practice’s PCC system to add the COVID-19 diagnosis.

PCC regularly updates your system’s ICD-10, LOINC, SNOMED-CT, NDC, RVU, VIS, and other standardized lists so you won’t encounter challenges when you chart, order a lab, interface with a care provider, or bill for a visit. (Your practice’s local system automatically updates your practice’s procedure codes.)

We decided to push the most recent SNOMED-CT codes and descriptions out as an immediate patch in order to provide practices with the new COVID-19 diagnosis.

Read the sections below to learn more.

COVID-19 Diagnosis

This update includes language and coding for a COVID-19 diagnosis.

  • 840539006 Disease caused by 2019-nCoV: This diagnosis has alternate, searchable names of “Disease caused by 2019 novel coronavirus” and “Disease caused by Wuhan coronavirus”.

If your practice needs to diagnose COVID-19, you can select this diagnosis on a chart note and/or add it to a patient’s Problem List.

What ICD-10 Code Do I Use for COVID-19?

On Thursday, March 19th, the CDC announced an unusual addition of a new ICD-10 code mid-cycle, making a new COVID-19 code effective as of April 1st, 2020:

  • U07.1 COVID-19

This code’s title has also appeared as “2019-nCoV acute respiratory disease”.

Prior to U07.1 COVID-19, the CDC recommends using specific codes for Pneumonia, Bronchitis, Lower Respiratory Infection, Respiratory Infection NOS, and ARDS, which you would add to a claim along with B97.29 Other coronavirus as the cause of diseases classified elsewhere. As always, payer response may vary.

PCC keeps an up-to-date handout with COVID-19 coding and billing recommendations here: 2020 COVID-19 Coding Guide. We will update that PDF link as the situation changes and we learn more.

Your practice can use the Billing Configuration tool to directly map one or more ICD-10 codes to a SNOMED diagnosis description.

For example, you could set up the Disease caused by 2019-nCoV code to automatically provide a selection of ICD-10 specific codes. In the configuration tool, you’d add codes to the ICD-10 mapping field:

When the clinician selects the diagnosis, they can choose the additional, specific codes to accompany B97.29:

New Favorites Available in Diagnosis Quick Search

The SNOMED-CT update adds 2600 diagnosis descriptions to your system. PCC added 78 of them to the “Favorites” quick search feature of all diagnosis fields in PCC EHR.

In preparation for the update, PCC’s certified coder, Jan Blanchard, assembled a list of 78 new SNOMED-CT descriptions of interest to pediatricians. The update added these diagnoses, which include the COVID-19 diagnosis, to your practice’s default Favorites list for quick searching, unless your practice has specifically requested otherwise.

What is a diagnosis 'Favorites' list?: As you type or search in any diagnosis field, PCC EHR automatically searches a customizable list of Favorites. Use the Diagnosis Configuration tool to adjust your practice’s list of Favorites. You can also right-click on any diagnosis field in PCC EHR to search your system’s full SNOMED-CT diagnosis library.

Abnormal hair findingAcquired stenosis of left nasolacrimal ductAcquired stenosis of right nasolacrimal duct
At increased risk of emergency hospital admissionBilateral itching of eyesBlister of skin
Bronchitis co-occurrent with acute wheezeBronchitis co-occurrent with chronic wheezeBronchitis co-occurrent with wheeze
Chronic excoriation of skinCold and clammy skinCrusting on nose
Disease caused by 2019-nCoVDislocation of digit of handDisorder caused by stimulant
Disorder due to vapingDry skin of abdomenDullness of light reflex at tympanic membrane
Erythema of skin of noseErythematous rashExcessive crying of infant
Excessive menstruation with irregular cycleFeeling abnormalForeign body of eye region
Glass foreign body in skinGonorrhea of lower genitourinary tractGonorrhea of penis
Hair tuft in skin of sacral regionHard lump of breastHarmful pattern of use of amphetamine and amphetamine derivative
Has special educational needsImmunization overdueImpulse control disorder caused by stimulant
Intermittent allergic asthmaItching of left eyeItching of right eye
Methamphetamine withdrawalMigration of intrauterine contraceptive deviceMisuse of medication
Mood disorder caused by cannabisMood disorder caused by methamphetamineNear fatal asthma
Neonatal jaundice due to ABO incompatibilityNicotine-filled electronic cigarette userNon-nicotine-filled electronic cigarette user
Obesity in adolescencePersistent adjustment disorderPimple of skin
Puncture wound of thumb with foreign bodyPuncture wound of thumb without foreign bodyPus crust on skin
Pustular psoriasis of palm of handPustular psoriasis of sole of footRash due to dribbling from mouth
Rash due to dribbling of urineRash of mouthRash of scalp
Requires vaccination against diphtheriaRequires vaccination against diphtheria-tetanus-pertussis with poliomyelitisRequires vaccination against diphtheria-tetanus-pertussis with typhoid-paratyphoid
Requires vaccination against measlesRequires vaccination against mumpsRequires vaccination against pertussis
Requires vaccination against typhoid-paratyphoidRough skinSexually assaultive behavior
Site of injection normalSplinter in ankleSplinter in eyelid
Strain of rotator cuff of shoulderStrain of tendon of handSynthetic cannabinoid induced mood disorder
Tingling painTransient motor ticVascular birthmark
Vesicle of skinWaxy discharge from ear

Deprecated SNOMED Diagnosis Descriptions

The March 2020 SNOMED-CT update removes or replaces many codes common to pediatric practices. Your practice may want to take special note of them.

  • Acute upper respiratory infection of multiple sites: This common URI diagnosis was removed from the international SNOMED-CT library as being ambiguous. Your practice may want to review alternative diagnoses and adjust chart note protocols, especially as it was often used for CQM reporting. PCC will automatically replace the term on chart note protocols for new visits with “Acute upper respiratory infection”, and there are several related URI descriptions available.

  • Lactose intolerance: PCC’s pediatric practices frequently used this SNOMED-CT diagnosis. It was removed from the SNOMED-CT library in favor of the more specific “Malabsorption syndrome due to intolerance to lactose”. PCC will automatically update your chart note protocols for new visits if this item appears as a default.

  • Infantile seborrheic dermatitis: This SNOMED-CT diagnosis, one of many formal names for “cradle cap”, was removed from the SNOMED-CT library. If your practice used it on a chart note protocol, the update will automatically replace it with “Generalized seborrheic dermatitis of infants”.

  • Here are the top 25 codes from PCC’s pediatric practices that have been removed from the SNOMED-CT diagnosis library in 2020. When these codes appeared for selection on a chart note protocol, PCC added a replacement. For other diagnoses, your providers may easily find related descriptions with a search, but you may want to plan ahead.

    Acute upper respiratory infection of multiple sites78337007
    Lactose intolerance267425008
    Infantile seborrheic dermatitis200776003
    Chesty cough161929000
    Acute wheezy bronchitis275499005
    Dysfunctional uterine bleeding19155002
    Fatigue – symptom272060000
    Pink eye disease241759005
    Pulled elbow95854004
    Oral contraceptive prescribed169472004
    Vesicular eczema of hands and/or feet402567004
    Periorbital and/or eye pain43751000119109
    Maternal drug abuse169941005
    Superficial bruising270911002
    Wry neck/torticollis270476009
    Facial eczema43523005
    Genetic syndrome290028006
    Fall down stairs414188008
    Eczema of leg309258000
    Uncomplicated umbilical hernia196867008
    Tiredness symptom267031002
    Feeling tired314109004
    Sprain, ankle joint, medial209531007

    SNOMED Codes Mapped to ICD-10 for Billing

    The SNOMED-CT update includes new mappings to ICD-10 billing codes. Many previous mappings have been updated.

    You may wish to review billing configuration for your diagnoses. You can open the Billing Configuration tool to configure which ICD-10 diagnoses are mapped to each SNOMED-CT description in PCC EHR. You can also use the snomedmap report to examine your practice’s diagnoses that may need updating.

    • Last modified: September 18, 2020