{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T13:26:47Z","timestamp":1791293207334,"version":"4.1.0"},"reference-count":28,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Online J Public Health Inform"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Post\u2013COVID-19 condition (colloquially known as \u201clong COVID-19\u201d) characterized as postacute sequelae of SARS-CoV-2 has no universal clinical case definition. Recent efforts have focused on understanding long COVID-19 symptoms, and electronic health record (EHR) data provide a unique resource for understanding this condition. The introduction of the International Classification of Diseases, Tenth Revision (ICD-10) code U09.9 for \u201cPost COVID-19 condition, unspecified\u201d to identify patients with long COVID-19 has provided a method of evaluating this condition in EHRs; however, the accuracy of this code is unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to characterize the utility and accuracy of the U09.9 code across 3 health care systems\u2014the Veterans Health Administration, the Beth Israel Deaconess Medical Center, and the University of Pittsburgh Medical Center\u2014against patients identified with long COVID-19 via a chart review by operationalizing the World Health Organization (WHO) and Centers for Disease Control and Prevention (CDC) definitions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients who were COVID-19 positive with either a U07.1 ICD-10 code or positive polymerase chain reaction test within these health care systems were identified for chart review. Among this cohort, we sampled patients based on two approaches: (1) with a U09.9 code and (2) without a U09.9 code but with a new onset long COVID-19\u2013related ICD-10 code, which allows us to assess the sensitivity of the U09.9 code. To operationalize the long COVID-19 definition based on health agency guidelines, symptoms were grouped into a \u201ccore\u201d cluster of 11 commonly reported symptoms among patients with long COVID-19 and an extended cluster that captured all other symptoms by disease domain. Patients having \u22652 symptoms persisting for \u226560 days that were new onset after their COVID-19 infection, with \u22651 symptom in the core cluster, were labeled as having long COVID-19 per chart review. The code\u2019s performance was compared across 3 health care systems and across different time periods of the pandemic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall, 900 patient charts were reviewed across 3 health care systems. The prevalence of long COVID-19 among the cohort with the U09.9 ICD-10 code based on the operationalized WHO definition was between 23.2% and 62.4% across these health care systems. We also evaluated a less stringent version of the WHO definition and the CDC definition and observed an increase in the prevalence of long COVID-19 at all 3 health care systems.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This is one of the first studies to evaluate the U09.9 code against a clinical case definition for long COVID-19, as well as the first to apply this definition to EHR data using a chart review approach on a nationwide cohort across multiple health care systems. This chart review approach can be implemented at other EHR systems to further evaluate the utility and performance of the U09.9 code.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2196\/53445","type":"journal-article","created":{"date-parts":[[2024,3,19]],"date-time":"2024-03-19T14:06:42Z","timestamp":1710857202000},"page":"e53445","source":"Crossref","is-referenced-by-count":17,"title":["Characterization of Post\u2013COVID-19 Definitions and Clinical Coding Practices: Longitudinal Study"],"prefix":"10.2196","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-8848-6171","authenticated-orcid":false,"given":"Monika","family":"Maripuri","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8890-8387","authenticated-orcid":false,"given":"Andrew","family":"Dey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5872-359X","authenticated-orcid":false,"given":"Jacqueline","family":"Honerlaw","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7056-9559","authenticated-orcid":false,"given":"Chuan","family":"Hong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3305-3830","authenticated-orcid":false,"given":"Yuk-Lam","family":"Ho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-8103-3474","authenticated-orcid":false,"given":"Vidisha","family":"Tanukonda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-4417-6932","authenticated-orcid":false,"given":"Alicia W","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0616-0403","authenticated-orcid":false,"given":"Vidul Ayakulangara","family":"Panickan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0011-5663","authenticated-orcid":false,"given":"Xuan","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6679-1464","authenticated-orcid":false,"given":"Harrison 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consortium for clinical characterization of COVID-19 by EHRCovidclinical.net2022-11-05https:\/\/covidclinical.net\/"},{"key":"ref16","unstructured":"Veterans Health AdministrationUS Department of Veterans Affairs2023-03-22https:\/\/www.va.gov\/health"},{"key":"ref17","unstructured":"By the numbers: UPMC facts and figuresUPMC2023-03-22https:\/\/www.upmc.com\/about\/facts\/numbers"},{"key":"ref18","unstructured":"About Beth Israel Deaconess Medical CenterBeth Israel Deaconess Medical Center2023-03-22https:\/\/www.bidmc.org\/about-bidmc"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1093\/biomet\/asab039"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1038\/nbt.2749"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1111\/j.2517-6161.1995.tb02031.x"},{"key":"ref22","unstructured":"Post COVID-19 condition (long COVID)World Health 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