A 33 minute read
February 4, 2020

On January 30, 2020, the spread of a novel strand of Coronavirus (nCov) was declared a global health emergency by the World Health Organization (WHO). The outbreak began in Wuhan—the capital city of China’s Hubei provincein December, with the country reporting approximately 10,000 cases so far and over 400 deaths. At the time of publication, there are about 100 reported cases in fewer than 20 other countries, with 2 reported deaths. 

What is Coronavirus? 

According to the Centers for Disease Control and Prevention (CDC), coronaviruses are a common family of viruses that generally cause mild to moderate upper-respiratory illnesses. These illnesses are zoonotic meaning they’re transmitted via contact with infected animals. Some recognizable coronaviruses include severe acute respiratory syndrome (SARS) and Middle Eastern Respiratory Syndrome (MERS). 

Coronavirus diagnosis volumes, 2019

Rank 

ICD-10 Code 

Description 

Total Diagnoses 

1. 

B9729 

Other coronavirus as the cause of diseases classified elsewhere 

6,487 

2. 

B342 

Coronavirus infection, unspecified 

6,118 

3. 

J1281 

Pneumonia due to SARS-associated coronavirus 

212 

4. 

B9721 

SARS-associated coronavirus as the cause of diseases classified elsewhere 

30 

Fig 1 Data from Definitive Healthcare’s hospital inpatient diagnosis analytics feature in the claims analytics platformFull-year 2019 hospital claims sourced through multiple clearinghouses. Accessed January 30, 2020. 

The first case of SARS, which originally appeared in 2002, was transmitted from civet cats. There have been no known transmissions of this virus since 2004. Its cousin, MERS, was originally transmitted to humans from dromedary camels. MERS first appeared in 2012, with a second outbreak recorded in 2015, but has since become extremely rare. 

Respiratory illnesses by diagnosis volume, 2019 

Rank 

ICD-10 Code 

Description 

Total Diagnoses 

1. 

J9601 

Acute respiratory failure with hypoxia 

1,607,503 

2. 

J449 

Chronic obstructive pulmonary disease, unspecified 

1,379,695 

3. 

J189 

Pneumonia, unspecified organism 

1,353,355 

4. 

J90 

Pleural effusion, not elsewhere classified 

1,008,806 

5. 

J441 

Chronic obstructive pulmonary disease with (acute) exacerbation 

924,020 

6. 

J45909 

Unspecified asthma, uncomplicated 

588,357 

7. 

J9811 

Atelectasis 

554,557 

8. 

J9621 

Acute and chronic respiratory failure with hypoxia 

536,035 

9. 

J9600 

Acute respiratory failure, unspecified whether with hypoxia or hypercapnia 

483,894 

10. 

J690 

Pneumonitis due to inhalation of food and vomit 

339,988 

Fig 2 Data from Definitive Healthcare’s hospital inpatient diagnosis analytics feature in the claims analytics platform. Full-year 2019 hospital claims sourced through multiple  clearinghousesAccessed January 30, 2020. 

How is the new Coronavirus (nCOV) different? 

On February 2, 2020, the CDC released a factsheet to promote public awareness about this new virus. The symptoms present much like those of other coronaviruses like SARS and MERS — meaning that patients are likely to experience fever, cough, shortness of breath and, in severe cases, pneumonia in one or both lungs. 

Despite this new viral outbreak, many experts say that the U.S. population has a more pressing respiratory concern: the flu. Since October 2019, the CDC estimates that more than 15 million U.S. patients have been diagnosed with the flu. Of these, more than 150,000 have been hospitalized and more than 8,000 have died.  

Last flu season, which ran from October 2018 through March 2019, the flu caused roughly 34,000 deaths. Experts speculate the flu is responsible for between 12,000 and 61,000 deaths in the U.S. each year, depending on the severity of the season. 

Influenza diagnosis volumes, 2019 

Rank 

ICD-10 Code 

Description 

Total Diagnoses 

1. 

J101 

Influenza due to other identified influenza virus with other respiratory manifestations 

91,537 

2. 

J111 

Influenza due to unidentified influenza virus with other respiratory manifestations 

38,848 

3. 

J09X2 

Influenza due to identified novel influenza A virus with other respiratory manifestations 

16,468 

4. 

J1000 

Influenza due to other identified influenza virus with unspecified type of pneumonia 

12,954 

5. 

J1008 

Influenza due to other identified influenza virus with other specified pneumonia 

9,578 

6. 

J1100 

Influenza due to unidentified influenza virus with unspecified type of pneumonia 

6,411 

7. 

J09X1 

Influenza due to identified novel influenza A virus with pneumonia 

6,056 

8. 

J1001 

Influenza due to other identified influenza virus with the same other identified influenza virus pneumonia 

2,894 

9. 

J1089 

Influenza due to other identified influenza virus with other manifestations 

1,818 

10. 

J1108 

Influenza due to unidentified influenza virus with specified pneumonia 

1,702 

Fig 3 Data from Definitive Healthcare’s hospital inpatient diagnosis analytics feature in the claims analytics platform. Does not include diagnosis volumes for influenza-related complications such as pneumonia. Full-year 2019 hospital claims sourced through multiple clearinghousesAccessed January 30, 2020. 

Coronavirus versus past epidemics 

Many viral outbreaks and pandemics reach the U.S., but few cause severe or lasting damage to the population. We’ve compiled intelligence from some of the most well-known epidemics of the past decade for comparison—Zika, Ebola, and H1N1

Zika diagnoses by claim year 

Zika is the most recent outbreak of a new epidemic and was declared a public health emergency in 2016 after it was first reported in South America. 

Claim Year 

ICD-10 Code 

Description 

Medicare Claims 

Medicare Charges 

2016 

A925 

Zika virus disease 

10 or fewer 

$13,814.12 

2017 

A925 

Zika virus disease 

10 or fewer 

$8,080.74 

2018 

A925 

Zika virus disease 

10 or fewer 

$5,784.84 

2019 

A925 

Zika virus disease 

10 or fewer 

$201.00 

2019 

Z20821 

Contact with and (suspected) exposure to Zika virus 

10 or fewer 

$1,303.22 

Fig 4 Data from Definitive Healthcare’s comprehensive claims analytics platform. Historical claim data only available from 2016 forward and pulled via Professional ServicesOnly includes principal diagnoses. Accessed January 31, 2020. 

Ebola diagnoses by claim year 

The 2014 Ebola outbreak, which began in West Africa, was the largest in recorded history. Ebola was originally identified in 1976 but saw a dramatic resurgence in 2014.

This is largely due to the epidemic’s origins in countries with weaker healthcare systems and lower incomes. In large rural areas without comprehensive healthcare coverage, communities are more likely to become overwhelmed by illness before patients can access proper treatment. 

Between August 2014 and March 2016, more than 30,000 people worldwide were infected with Ebola—with as many as 11,000 reported deaths. An additional Ebola emergency was declared last year, with an outbreak beginning in the Democratic Republic of the Congo. 

Claim Year 

ICD-10 Code 

Description 

Medicare Claims 

Medicare Charges 

2016 

A984 

Ebola virus disease 

10 or fewer 

$665.02 

2017 

A984 

Ebola virus disease 

10 or fewer 

$927.97 

2018 

A984 

Ebola virus disease 

10 or fewer 

$177.00 

2019 

A984 

Ebola virus disease 

10 or fewer 

$8,765.29 

Fig 5 Data from Definitive Healthcare’s comprehensive claims analytics platform. Historical claim data only available from 2016 forward and pulled via Professional Services. Only includes principal diagnoses. Accessed January 31, 2020. 

H1N1 (Swine Flu) diagnoses by claim year 

The H1N1 virus, colloquially known as “swine flu, took hold in 2009. Reported deaths from the disease ranged from 123,000 to more than 575,000 globally. Human H1N1 infections declined drastically after October 2009, and is no longer considered a pandemic—it is, however, a regular human flu virus that circulates seasonally worldwide.

Claim Year 

ICD-10 Code 

Description 

Medicare Claims 

Medicare Charges 

2015 

J09X2 

Influenza due to identified novel influenza A virus with other respiratory manifestations 

227 

$908,332.37 

2016 

J09X2 

Influenza due to identified novel influenza A virus with other respiratory manifestations 

6,081 

$24,790,455.07 

2017 

J09X2 

Influenza due to identified novel influenza A virus with other respiratory manifestations 

20,400 

$73,190,721.13 

2018 

J09X2 

Influenza due to identified novel influenza A virus with other respiratory manifestations 

17,381 

$55,368,861.39 

2019 

J09X2 

Influenza due to identified novel influenza A virus with other respiratory manifestations 

11,164 

$34,470,671.44 

Fig 6 Data from Definitive Healthcare’s comprehensive claims analytics platform. Historical claim data only available from 2015 forward and pulled via Professional Services. Only includes principal diagnoses. Accessed January 31, 2020. 

Learn more 

Are you looking for more information on how to use medical claims analytics to improve your success at selling to healthcare providers? Watch our on-demand webinar,  How to Use Commercial Claims to Drive New Sales, hosted by Definitive Healthcare Chief Executive Officer Jason Krantz and Chief Revenue Officer Joe Mirisola. 

During this webinar, attendees will learn how to effectively research, craft messaging for, and sell to healthcare leaders and clinicians via medical claims. See for yourself how to: 

  • Identify claims volumes by CPT, ICD, or DRG code and access diagnosis trends from 2015 forward 
  • Access insights on payor mix at the facility or physician level 
  • Examine referral patterns between care facilities and physicians to identify key behaviors and relationships 

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