Coding for COVID-19

Minor changes to OSIICS version 13 (versions 13.1–13.5) have been made over 2020 and 2021. Just prior to releasing version 13.1, an email was sent to other members of the IOC consensus team asking ‘Do you think this new viral illness, COVID-19, warrants a specific code?’ At that early stage, some respondents thought that for a sports diagnostic system it would be unjustified to start differentiating between virus types. As the impact of the pandemic became obvious, the need for differentiation was appreciated and the code MPIC was created for COVID-19 infection. The WHO has also created emergency codes related to COVID-19 for International Classification of Diseases (ICD)-10 and ICD-11.3

Already there have been additional codes related to the consensus statement on cycling injuries.4 Other expansions to OSIICS version 14 (online supplemental file 2) are additional sports cardiology diagnoses and female health conditions and further coding related to COVID-19 and even health conditions related to the vaccines (table 1).

The need for specific sports injury coding systems (such as OSIICS and SMDCS) remains, as our ‘common’ sports injury diagnoses such as hamstring strain are not easily found in ICD codes.1 2 5 It has been important to add more illness codes as we continue to recognise the importance of tracking athlete illness as well as injury.6

Diagnoses and coding

In the sports and exercise medicine (SEM) specialty, it is also worth recognising that specific diagnosis is being questioned depending on the clinical scenario. For young elite athletes with (hopefully) little background degenerative change of the musculoskeletal system, specific diagnosis retains much of its traditional value. This is particularly for prognosis, as there is less background pathology to complicate diagnosis and in many cases imaging findings do correlate with recovery time. For the middle-aged or elderly patient, the huge value of promoting exercise and helping these patients access SEM services is becoming more apparent, but the value of specific diagnosis is less obvious in many cases. In fact, there is some evidence that the search for tissue-specific diagnoses can be harmful in terms of outcomes in musculoskeletal medicine.7 A meniscal tear of the knee or an acute lumbar disc prolapse is an important finding in a 21-year-old athlete, but we now legitimately question whether these diagnoses have any value whatsoever in those aged 60–70 years old, when the vast majority of the population will have evidence of these findings on asymptomatic screening imaging.8 It is therefore important that the OSIICS allows non-specific diagnostic codes and that practitioners use these with comfort when they are in situations where specific diagnoses are not warranted.

An Italian translation

OSIICS version 14 also comes with an Italian language version for the first time (curated by FG), which reflects its popularity in Europe in particular. Previous versions have been published in Spanish9 and Catalan10; any further language translations are welcome and will be added to free downloads, although it is possible to do a basic translation into most languages now with services such as Google Translate. OSIICS remains open-source and free to use with attribution.