An Accountable Care Organization Maintains Access for Appendicitis During the COVID-19 Pandemic

•The COVID-19 pandemic was not associated with a significant increase in the incidence or severity of acute appendicitis among the pediatric Medicaid population of central and southeastern Ohio.•A well-established accountable care organization may have played a significant role in maintaining access to prompt surgical care during the pandemic.•The ICD-10-CM coding system has made significant improvements in the accuracy of the diagnosis; however, a significant margin of error remains. Caution should be utilized when using these codes for large database studies and further modifications to the verbiage to eliminate ambiguity is warranted.