COVID-19 is a complex disease with a wide spectrum of clinical patterns. COVID-19 was initially viewed as primarily a respiratory disease, but is now recognized as a complex disorder affecting many body systems. Coding professionals need to be knowledgeable of the testing of COVID-19 (e.g., diagnostic and antibody tests) and the COVID-19 disease processes (e.g., thrombolysis and connective tissue disorders).
Determining POA status of COVID-19 and it’s manifestations is not always easily determined. The CDC (Centers for Disease Control and Prevention) has stated that symptoms of COVID-19 may appear 2-14 days after exposure. Evidence suggests that testing trends to be less accurate within three days of exposure, and the best time to get tested is five to seven days after you were exposed. It is critically important to assign the most accurate POA indicator for COVID-19 in order to facilitate data quality.
Because of the difficulties ascertaining the date the infection occurred, whether before or after admission, it would be appropriate to query the physician for clarification of the POA indicator. An example of a COVID-19 POA query would be:
Please clarify if COVID-19 was:
- POA at the time of the order to admit patient to inpatient status
- Not POA and developed during the inpatient stay
- Clinically unable to determine if the condition was present on admission