Q&A: Sequencing for sepsis and COVID-19

Q: We have had patients admitted with both sepsis and the novel coronavirus (COVID-19). How should these two diagnoses be sequenced in ICD-10-CM?

A: Coding for sepsis with COVID-19 will be dependent on the circumstances of the admission. If the patient is admitted for COVID-19 and the patient develops viral sepsis after admission, per the Centers for Disease Control and Prevention’s latest sepsis sequencing guidelines, the codes would be sequenced as U07.1 (COVID-19) and A41.89 (other specified sepsis) with the systemic infection first.

However, COVID-19 does not always have to be the principal diagnosis. If the patient had sepsis and meets the documentation requirements for being present on admission per the sepsis guidelines, the systemic infection would be sequenced first, followed by the COVID-19 diagnosis.

Editor’s note: This question was answered by Shannon McCall, RHIA, CCS, CCS-P, CPC, CEMC, CRC, CCDS, CCDS-O, director of HIM and coding for HCPro in Middleton, Massachusetts.

This answer was provided based on limited information. Be sure to review all documentation specific to your own individual scenario before determining appropriate code assignment.