{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T08:01:33Z","timestamp":1793174493139,"version":"4.5.0"},"reference-count":32,"publisher":"American Medical Association (AMA)","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n A significant proportion of SARS-CoV-2 infected individuals experience post\u2013COVID-19 condition months after initial infection.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n \n To determine the rates, clinical setting, risk factors, and symptoms associated with the documentation of\n International Statistical Classification of Diseases Tenth Revision<\/jats:italic>\n (\n ICD-10<\/jats:italic>\n ), code U09.9 for post\u2013COVID-19 condition after acute infection.\n <\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n \n This retrospective cohort study was performed within the US Department of Veterans Affairs (VA) health care system. Veterans with a positive SARS-CoV-2 test result between October 1, 2021, the date\n ICD-10<\/jats:italic>\n code U09.9 was introduced, and January 31, 2023 (n\u2009=\u2009388\u202f980), and a randomly selected subsample of patients with the U09.9 code (n\u2009=\u2009350) whose symptom prevalence was assessed by systematic medical record review, were included in the analysis.\n <\/jats:p>\n <\/jats:sec>\n \n Exposure<\/jats:title>\n Positive SARS-CoV-2 test result.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n \n Rates, clinical setting, risk factors, and symptoms associated with\n ICD-10<\/jats:italic>\n code U09.9 in the medical record.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Among the 388\u202f980 persons with a positive SARS-CoV-2 test, the mean (SD) age was 61.4 (16.1) years; 87.3% were men. In terms of race and ethnicity, 0.8% were American Indian or Alaska Native, 1.4% were Asian, 20.7% were Black, 9.3% were Hispanic or Latino, 1.0% were Native Hawaiian or Other Pacific Islander; and 67.8% were White. Cumulative incidence of U09.9 documentation was 4.79% (95% CI, 4.73%-4.87%) at 6 months and 5.28% (95% CI, 5.21%-5.36%) at 12 months after infection. Factors independently associated with U09.9 documentation included older age, female sex, Hispanic or Latino ethnicity, comorbidity burden, and severe acute infection manifesting by symptoms, hospitalization, or ventilation. Primary vaccination (adjusted hazard ratio [AHR], 0.80 [95% CI, 0.78-0.83]) and booster vaccination (AHR, 0.66 [95% CI, 0.64-0.69]) were associated with a lower likelihood of U09.9 documentation. Marked differences by geographic region and facility in U09.9 code documentation may reflect local screening and care practices. Among the 350 patients undergoing systematic medical record review, the most common symptoms documented in the medical records among patients with the U09.9 code were shortness of breath (130 [37.1%]), fatigue or exhaustion (78 [22.3%]), cough (63 [18.0%]), reduced cognitive function or brain fog (22 [6.3%]), and change in smell and\/or taste (20 [5.7%]).<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n \n In this cohort study of 388\u202f980 veterans, documentation of\n ICD-10<\/jats:italic>\n code U09.9 had marked regional and facility-level variability. Strong risk factors for U09.9 documentation were identified, while vaccination appeared to be protective. Accurate and consistent documentation of U09.9 is needed to maximize its utility in tracking patients for clinical care and research. Future studies should examine the long-term trajectory of individuals with U09.9 documentation.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2023.46783","type":"journal-article","created":{"date-parts":[[2023,12,8]],"date-time":"2023-12-08T11:31:00Z","timestamp":1702035060000},"page":"e2346783","source":"Crossref","is-referenced-by-count":30,"title":["Rates of\n ICD-10<\/i>\n Code U09.9 Documentation and Clinical Characteristics of VA Patients With Post\u2013COVID-19 Condition"],"prefix":"10.1001","volume":"6","author":[{"given":"Pandora L.","family":"Wander","sequence":"first","affiliation":[{"name":"Division of General Internal Medicine, Veterans Affairs (VA) Puget Sound Health Care System and University of Washington, Seattle"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron","family":"Baraff","sequence":"additional","affiliation":[{"name":"Seattle Epidemiologic Research and Information Center, VA Puget Sound Health Care System, Seattle, Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Fox","sequence":"additional","affiliation":[{"name":"Seattle Epidemiologic Research and Information Center, VA Puget Sound Health Care System, Seattle, Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly","family":"Cho","sequence":"additional","affiliation":[{"name":"VA Centralized Interactive Phenomics Resources\u2013VA Boston Healthcare System, Boston, Massachusetts"},{"name":"Department of Medicine, Mass General Brigham, Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monika","family":"Maripuri","sequence":"additional","affiliation":[{"name":"VA Centralized Interactive Phenomics Resources\u2013VA Boston Healthcare System, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacqueline P.","family":"Honerlaw","sequence":"additional","affiliation":[{"name":"VA Centralized Interactive Phenomics Resources\u2013VA Boston Healthcare System, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuk-Lam","family":"Ho","sequence":"additional","affiliation":[{"name":"VA Centralized Interactive Phenomics Resources\u2013VA Boston Healthcare System, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew T.","family":"Dey","sequence":"additional","affiliation":[{"name":"VA Centralized Interactive Phenomics Resources\u2013VA Boston Healthcare System, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann M.","family":"O\u2019Hare","sequence":"additional","affiliation":[{"name":"Division of Nephrology, VA Puget Sound Healthcare System and University of Washington, Seattle"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy S. B.","family":"Bohnert","sequence":"additional","affiliation":[{"name":"VA Center for Clinical Management Research, Ann Arbor, Michigan"},{"name":"Department of Psychiatry, University of Michigan Medical School, Ann Arbor"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward J.","family":"Boyko","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine, Veterans Affairs (VA) Puget Sound Health Care System and University of Washington, Seattle"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew L.","family":"Maciejewski","sequence":"additional","affiliation":[{"name":"Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health Care System, Durham, North Carolina"},{"name":"Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina"},{"name":"Duke-Margolis Center for Health Policy, Duke University School of Medicine, Durham, North Carolina"},{"name":"Division of General Internal Medicine, Duke University School of Medicine, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Viglianti","sequence":"additional","affiliation":[{"name":"Center for Clinical Management Research, VA Ann Arbor Health System, Ann Arbor, Michigan"},{"name":"Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theodore J.","family":"Iwashyna","sequence":"additional","affiliation":[{"name":"Center for Clinical Management Research, VA Ann Arbor Health System, Ann Arbor, Michigan"},{"name":"Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denise M.","family":"Hynes","sequence":"additional","affiliation":[{"name":"Center of Innovation to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, Oregon"},{"name":"Health Management and Policy, School of Social and Behavioral Health Sciences, College of Public Health and Human Sciences, Health Data and Informatics Program, Center for Genome Research and Biocomputing, Oregon State University, Corvallis"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas F.","family":"Osborne","sequence":"additional","affiliation":[{"name":"VA Palo Alto Health Care System, Palo Alto, California"},{"name":"Department of Radiology, Stanford University School of Medicine, Stanford, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George N.","family":"Ioannou","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, VA Puget Sound Health Care System and University of Washington, Seattle"},{"name":"Research and Development, VA Puget Sound Health Care System, Seattle, 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