Comprehensive Code List Associated with Underlying Medical Conditions Identified by the CDC as High-Risk Factors for Progression to Severe COVID-19 Outcomes

Abstract

A list of diagnosis codes mapped to CDC-defined high-risk conditions for severe COVID-19 outcomes is currently not available in the literature. We reviewed the CDC list of underlying conditions associated with severe COVID-19 and a coding expert and two clinicians mapped the relevant high-risk conditions to the appropriate ICD-10-CM codes. We additionally assessed the prevalence of these conditions in the Optum de-identified-Clinformatics® Data Mart Database and the Optum de-identified Electronic Health Record dataset. A comprehensive list of approximately 8200 codes were mapped to the CDC-defined high-risk underlying conditions; these ICD-10-CM codes were stratified into three groups corresponding with the CDC strength of evidence category (conclusive, suggestive, or mixed evidence). Applying these codes to administrative claims and EHR datasets demonstrated a consistent prevalence of high-risk conditions over four years (2018–2021). These findings present a comprehensive list of codes that can be used by clinicians and researchers to identify and characterize patients at high risk for severe COVID-19 outcomes.

Keywords

• COVID-19
• SARS-CoV-2
• severe COVID-19
• high-risk comorbidities
• ICD-10-CM