Based on the information provided in the case study and the search results, the following ICD-10-CM codes can be assigned:
- U07.1, COVID-19: This code should be assigned as the principal diagnosis, as COVID-19 is the primary cause of the pneumonia in this case.
- J12.82, Pneumonia due to coronavirus disease 2019: This code can be assigned as an additional diagnosis to specifically indicate that the pneumonia is related to COVID-19.
Primary Diagnosis:
- U07.2 - COVID-19 pneumonia, confirmed
Secondary Diagnoses:
- O99.51 - Diseases of the respiratory system complicating pregnancy
- J18.9 - Pneumonia, unspecified
- R78.0 - Fever
- External Cause Code (if applicable):
- Z20.821 - Contact with and exposure to SARS-CoV-2
Coding Rationale:
- U07.2: This code is the most specific code for COVID-19 pneumonia, confirmed by clinical criteria.
- O99.51: This code indicates that the pneumonia is complicating pregnancy.
- J18.9: This code is used for pneumonia of unspecified etiology, which is appropriate in this case since other causes were ruled out.
- R78.0: This code is used to report the patient's fever.
- Z20.821: This code indicates the patient's contact with and exposure to SARS-CoV-2, which is likely the cause of her illness.
There are no external cause codes provided in the search results that are relevant to this case study. If you have any questions or need further assistance, please feel free to ask.
Complete question:
Using the techniques described in this chapter, carefully read through the case study and determine the most accurate ICD-10-CM code(s) and external cause code(s), if appropriate. Remember, check the chapter specific, sub-chapter-specific, and category-specific notations within the Tabular list. Patient: Marlene Smithson Physician: Jason Nuouri, MD July 16, 2021
CASE STUDY 10: Marlene Smithson Marlene Smithson, a 31-year-old pregnant female, G1 P0, at 28 weeks, 5 days gestation, developed a cough with expectoration on March 26, 2022. On March 27, she developed a fever, with her body temperature fluctuating between 99 F and 101 F. She was admitted to the hospital with common pneumonia and treated with oral cephalosporin for 3 days. Her pulmonary computed tomography (CT) scan on March 30, 2022 (29 weeks, 2 days gestation) showed scattered consolidation and ground-glass shadow of both lungs. In addition, the routine blood test results showed that her white blood cell count was extraordinarily high. She tested negative for influenza A and B virus antigens, Mycoplasma pneumoniae, and Chlamydia pneumoniae. Based on the criteria of COVID-19 pneumonia in the New Coronavirus Prevention and Control Program (5th edition) dated February 3, 2022, she was diagnosed as a clinically confirmed case, so quarantine treatment including nebulized inhalation and oral cephalosporin could begin. Five days later (30-weeks gestation), patient’s body temperature returned to normal and the symptoms, including cough and expectoration, disappeared. Subsequently, the pharyngeal swab test of SARS-CoV-2 revealed twice negative on April 5 and April 7, 2022. Be sure to list the codes, one code per box, in the correct order, from top to bottom. Capitalization, punctuation, and spacing can impact whether or not your answer is correct. Follow coding best practices. What is/are the correct diagnosis code(s)?