Concept: Coronavirus (COVID-19) Coding and Data Sources

Introduction

In Manitoba, the coronavirus (COVID-19) appeared in early 2020 and new methods for identifying, tracking and treating the infection were developed. This concept identifies the data sources used to collect this information and a description of how information about the novel coronavirus (COVID-19) is recorded in each data source.

Repository Data Sources

Currently, there are 10 data sets in the Manitoba Population Research Data Repository that contain information directly related to the identification, tracking and treatment of the coronavirus (COVID-19). This includes:


1. COVID-19 Lab Testing and Results data;
   
2. COVID-19 Surveillance - Cases and Contacts data.
   
3. COVID-19 Vaccinations, Appointments and Screening data.
4. specific tariff and modified ICD-9 diagnoses codes in the Medical Services / Physician Claims data;
   
5. specific ICD-10-CA diagnoses codes and CCI intervention codes in the Hospital Abstracts data;
   
6. specific ICD-10-CA diagnoses codes in the Emergency Department Information System (EDIS) data;
   
7. specific ICD-10-CA diagnoses codes in the Critical Care and Medicine (CCMED) data;
   
8. specific immunization codes in the Manitoba Immunization Registry - Public Health Information Management System (PHIMS) data;
   
9. specific ICD-9 diagnoses codes in the Canadian Primary Care Sentinel Surveillance Network (CPCSSN) / Electronic Medical Record (EMR) data.
   
10. specific ICD-10 diagnosis codes in the Vital Statistics Mortality Registry data.

1. COVID-19 Lab Testing and Results Data

Highlights of the COVID-19 Lab Testing and Results data includes laboratory test information (e.g.: reason, test name) and result, test collection site information (e.g.: name, type), patient date of birth and postal code, and whether the patient is an essential worker, first responder or health care worker. This data is currently updated monthly.

For more detailed information on the contents of the COVID-19 Lab Testing and Results data, see the COVID-19 Lab Testing and Results Data Description information on our website.

2. COVID-19 Surveillance - Cases and Contacts Data

The COVID-19 Surveillance - Cases and Contacts data includes information on lab confirmed and probable COVID-19 cases, and contact information for each of these cases. Highlights of the Cases data include whether they were hospitalized or in an Intensive Care Unit (ICU), admit dates for hospitalization and/or ICU, length of stay in hospital/ICU, a list of symptoms and onset date, and date of death, if applicable. Highlights of the Contacts data include a link to the Case, ethnicity data, type of exposure, and type of contact with the case. This data is currently updated monthly.

For more detailed information on the contents of the COVID-19 Surveillance - Cases and Contacts data, see the COVID-19 Surveillance - Cases and Contacts Data Description information on our website.

3. COVID-19 Vaccinations, Appointments and Screening Data

The COVID-19 Vaccinations, Appointments and Screening data includes vaccination data related only to COVID-19 vaccinations in Manitoba. Highlights of the vaccination data include: client birthdate, gender and postal code; number of doses received; delivery location and organization; immunization reason; SNOMED code and description; and vaccination date. This data also contains information on COVID-19 vaccination appointments and vaccination screening information related to COVID-19.

All of this data is currently updated monthly in the Repository.

For more detailed information on the contents of the COVID-19 Vaccinations, Appointments and Screening data, see the COVID-19 Vaccinations, Appointments and Screening Data Description information on our website.

4. Medical Services / Physician Claims Data

The following tariff codes and ICD-9 diagnoses codes were updated in the Physician Tariff Manual from Manitoba Health, Seniors and Active Living (MHSAL) for recording coronavirus-related information in the Medical Services / Physician Claims data. This includes several updates for COVID-19 related tariff / diagnosis codes from March 2020 to March 2022.

For a complete listing of all virtual or telephone physician visits, please see the Virtual or Telephone Physician Visits concept.

March 14, 2020 Update

The following new temporary tariff codes were available for support of COVID-19 as of March 14, 2020:



Tariff Code	Description
78321	Virtual Visit by Telephone or Video
78533	Virtual Psychotherapy by Telephone or Video

November 17, 2020 Update

The following new tariff codes are available for support of COVID-19 as of November 17, 2020:



Tariff Code	Description
78888	Office Visit for COVID-19 with or without test
78284	Virtual Visit by telephone or video - patient aged 65-69 years
78285	Virtual Visit by telephone or video - patient aged 70 years or over
78442	Comprehensive Virtual Assessment by General Practitioner
78447	Comprehensive Virtual Assessment by Specialist
78775	Immunization - Influenza - High Dose

The following ICD-9 diagnoses codes were modified by MHSAL to allow the recording of medical conditions related to COVID-19:



ICD-9 Code	Current Interpretation of Descriptor*	Original Code Descriptor
V0182	Exposure to COVID-19	Exposure to SARS
07982	COVID-19 Associated Coronavirus	SARS Associated Coronavirus
4803	Pneumonia due to COVID-19	Pneumonia due to SARS

NOTE: * Temporary Manitoba descriptor interpretations, effective November 2019

2021 Forward Vaccine Updates

The following tariff codes are available from 2021 forward for recording the different COVID-19 vaccines administered in Manitoba:



Tariff Code	Description
78160	PFIZER XBB.1.5 VACCINE (12+ YEARS OF AGE) $20.00
78161	MODERNA -XBB.1.5 VACCINE (12+ YEARS OF AGE) $11.57
78162	MODERNA -XBB.1.5 - 0.1MG/ML (6 MONTHS - 11 YEARS OF AGE) $20.00
78163	NOVAVAX XBB.1.5 COVID - 19 $20.00
78165	PFIZER PEDIATRIC XBB.1.5 VACCINE (5 - 11 YEARS OF AGE) $20.00
78166	PFIZER INFANT XBB.1.5 VACCINE (6 MONTHS - 4 YEARS OF AGE) $20.00
78221	PFIZER (COMIRNATY) Bivalent BA4/5
78227	MODERNA (SPIKEVAX) BIVALENT BA4/5
78251	PFIZER vaccine
78252	MODERNA vaccine
78255	JOHNSON & JOHNSON / JANSSEN vaccine
78256	ASTRA ZENECA vaccine
78261	MODERNA (SPIKEVAX) - INFANT PEDIATRIC
78263	PFIZER (COMIRNATY) - INFANT (6months-4 YEARS)
78266	MODENA (SPIKEVAX) - BIVALENT
78267	PFIZER (COMIRNATY) BIVALENT
78291	NUVAXOVID (NOVAVAX COVID-19 vaccine)
78292	COVID-19 Pfizer-Biontech Pediatric vaccine
78293	MODERNA 50MCG Half Dose 0.25ML vaccine


The following COVID-19 related tariff code was also introduced in 2021:



Tariff Code	Description
78330	COVID-19 Immunization Hesitancy Advice

March 2022 Updates - COVID-19 Testing

The following COVID-19 related tariff codes were introduced in March 2022:



Tariff Code	Description
79211	COVID-19 RAPID ANTIGEN DETECTION TEST (RAT)
79212	COVID-19 NASOPHARYNGEAL SWAB FOR POLYMERASE CHAIN REACTION (PCR) TEST

5. Hospital Abstracts Data

The following ICD-10-CA codes were introduced by the Canadian Institute for Health Information (CIHI) for recording diagnoses related to COVID-19 in the Hospital Abstracts data.

CAUTIONS:

• These ICD-10-CA codes first appear in the 2020/2021 Hospital Abstracts data.
  
  

  Diagnosis Code	Description
  U07.1	COVID-19, virus identified
  U07.2	COVID-19, virus not identified
  U07.3	Multisystem inflammatory syndrome (MIS) associated with COVID-19
  U07.4	Post COVID-19 condition (coded as Diagnosis Type 3 - Other Problem related to the Most Responsible Diagnosis)
  U07.5	Personal History of COVID-19
  U07.6	Need for immunization against COVID-19
  U07.7	COVID-19 vaccines causing adverse effects in therapeutic use


The following CCI code was also introduced to identify the COVID-19-related vaccination administered in-hospital.



CCI Intervention Code	Code Description
8.IM.70.HA.ZZ	Vaccination against COVID-19 - to prevent severe acute respiratory syndrome coronavirus 2 [SARS CoV 2] by intramuscular [IM] injection of agent or substance NEC

6. Emergency Department Information System (EDIS)

The Emergency Department Information System (EDIS) data captures up to two discharge diagnoses codes, coded in ICD-9-CM or ICD-10-CA, depending on the year of data. The COVID-related ICD-10-CA diagnoses codes are the same as those documented for the Hospital Abstracts data.

7. Critical Care and Medicine (CCMED) Data

The Critical Care and Medicine (CCMED) data captures a diagnosis code, coded in ICD-10-CA. The COVID-related ICD-10-CA diagnoses codes are the same as those documented for the Hospital Abstracts data.

8. Manitoba Immunization Registry - Public Health Information Management System (PHIMS) Data

The Manitoba Immunization Registry - Public Health Information Management System (PHIMS) data contains information on all vaccines administered in the province, including the following COVID-19 vaccines and related services:


SNOMED Code	SNOMED Description	Tariff Code	Tariff Code Description
28571000087109	COVID19-Moderna	8252	78252 - MODERNA - PER DOSE $20.00
28581000087106	COVID19-Pfizer	8251	78251 - PFIZER-BIONTECH - PER DOSE $20.00
28761000087108	COVID19-Astra Zeneca	8256	78256 - ASTRA ZENECA - PER DOSE $20.00
28761000087108	COVID19-AZ/COVISHIELD	8256	78256 - ASTRA ZENECA - PER DOSE $20.00
28951000087107	COVID19-Johnson & Johnson / Janssen	8255	78255 - JOHNSON & JOHNSON/JANSSEN - PER DOSE $20.00
29171000087106	COVID19-Novavax	8291	78291 - NUVAXOVID (NOVAVAX COVID-19 VACCINE - PER DOES $20.00
33361000087101	COVID19-Pfizer Pediatric	8292	78292 - PFIZER-BIONTECH PEDIATRIC VACCINE - PER DOSE $20.00
34611000087105	COVID19-Pfizer Infant Pediatric	8263	PFIZER (COMIRNATY) - INFANT (6 MONTHS-4 YEARS)
35651000087105	COVID19-Moderna Infant Pediatric	8261	MODERNA (SPIKEVAX) - INFANT PEDIATRIC
37311000087109	COVID19-Moderna Bivalent	8266	MODERNA (SPIKEVAX) - BIVALENT - PER DOSE $20.00
37691000087106	COVID19-Pfizer BA.4/5 Bivalent	8267	PFIZER (COMIRNATY) BIVALENT - PER DOSE $20.00
38591000087106	COVID19-Moderna BA.4/5 Bivalent	8227	MODERNA (SPIKEVAX) BIVALENT BA4/5 $20.00
51481000087102	COVID19-Moderna XBB.1.5	8161	78161 - MODERNA XBB.1.5 VACCINE (12+ Years of Age) $11.57
MB8228	COVID19-Moderna BA.4/5 Bivalent	8227	MODERNA (SPIKEVAX) BIVALENT BA4/5 $20.00
MB8293	COVID19-Moderna Half Dose	8293	78293 - MODERNA 50MCG HALF DOSE 0.25ML - PER DOSE $20.00
TBD_78160	COVID19-TBD_78160	8160	78160 - PFIZER XBB.1.5 VACCINE (12+ Years of Age) $20.00
TBD_78162	COVID19-TBD_78162	8162	78162 - MODERNA-XBB.1.5-0.1MG/ML (6 MONTHS - 11 YEARS OF AGE) $20.00
TBD_78163	COVID19-TBD_78163	8163	78163 - NOVAVAX XBB.1.5 COVID-19 $20.00
TBD_78165	COVID19-TBD_78165	8165	78165 - PFIZER PEDIATRIC XBB.1.5 VACCINE (5-11 YEARS OF AGE) $20.00
TBD_78166	COVID19-TBD_78166	8166	78166 - PFIZER INFANT XBB.1.5 VACCINE (6 MONTHS - 4 YEARS OF AGE) $20.00
TBD_78221	COVID19-TBD_78221	8221	78221 - PFIZER (COMIRNATY) BIVALENT BA4/5 $20.00
TBD_78291	COVID19-TBD_78291	8291	NUVAXOVID (NOVAVAX COVID-19 VACCINE) - PER DOSE $20.00
TBD_78330	COVID19-TBD_78330	8330	COVID-19 IMMUNIZATION HESITANCY ADVICE
TBD_89211	COVID19-TBD_89211	9211	COVID-19 RAPID ANTIGEN DETECTION TEST (RAT) $15.00
TBD_89212	COVID19-TBD_89212	9212	COVID-19 NASOPHARYNGEAL SWAB FOR POLYMERASE CHAIN REACTION (PCR) TEST $15.00

The following SNOMED codes identify additional vaccines recorded in the data, but they do not have associated tariff codes:

SNOMED Code	Description
02526271	COVID19-MAB Tixagevimab and Ci
1162694008	COVID19-MAB Sotrovimab
1162705007	COVID19-MAB Casirivimab and Im
29171000087106	COVID19-Covovax/Novovax
31301000087101	COVID19-Sinopharm/BIBP
31311000087104	COVID19-Coronavac/Sinovac
31341000087103	COVID19-Sputnik V
31431000087100	COVID19-Convidecia (Ad5-nCoV)
33211000087105	COVID19-Covaxin
33391000087109	COVID19-Abdala/CIGB
33411000087109	COVID19-CoviVac
33431000087104	COVID19-KConVac/Minhai
33461000087106	COVID19-Sputnik Light
33471000087102	COVID19-Zifivax/ZFSW
34921000087108	COVID19-Covovax
37701000087106	COVID19-Pfizer BA 4/5 Pediatric
37871000087108	COVID19-Pfizer BA.1 Bivalent

NOTE: Manitoba COVID-19 vaccine data is available beginning in December 2020. Each vaccine has a different implementation date. The Manitoba Immunization Registry data in the Repository is updated monthly.

A specific dataset containing only COVID-19 related vaccination information is described above in section 3 COVID-19 Vaccinations - Weekly Data of this concept.

9. Canadian Primary Care Sentinel Surveillance Network (CPCSSN) Data

The Canadian Primary Care Sentinel Surveillance Network (CPCSSN) data is comprised of electronic medical record (EMR) information collected from participating primary care providers. The data held in the Data Repository contains Manitoba data only, extracted by the Manitoba Primary Care Research Network (MaPCReN), a node of the CPCSSN.

The following COVID-19-related ICD-9 diagnosis codes are being used to track health conditions and encounter diagnosis related to the coronavirus:

ICD-9 Code	Code Description
079.82	SARS-ASSOCIATED CORONAVIURS
480.3	PNEUMONIA DUE TO SARS-ASSOCIATED CORONAVIURS
V01.82	EXPOSURE TO SARS-ASSOCIATED CORONAVIURS

NOTE: COVID-19 related diagnosis codes begin appearing in the CPCSSN data in mid-March, 2020.

10. Vital Statistics Mortality Registry Data

The most recent Vital Statistics Mortality Registry data contains ICD-10 diagnosis codes for the "primary cause of death" and multiple "underlying cause of death" variables.

The following COVID-19-related ICD-10 diagnosis codes are being recorded in the primary and underlying cause of death variables:

ICD-10 Diagnosis Code	Description
U07.1	COVID-19, virus identified
U07.2	COVID-19, virus not identified 19

NOTE: COVID-19 related diagnosis codes began appearing in the mortality data in 2020.

Cautions / Limitations

The specific COVID-19 related diagnoses/tariff codes were not available for use when the pandemic started, so even if a patient presented with COVID, or the doctor wanted to bill for this situation, they could not because the codes were not available for use at that time. They would have to use alternate diagnoses/tariffs already available in the system. So, there is a potential "data gap" in the hospital abstracts, medical claims / medical services, and CPCSSN data.