Administrative coding methods impact surgical site infection rates

2020 ◽  
Vol 41 (12) ◽  
pp. 1461-1463
Author(s):  
Mohammed A. Alsuhaibani ◽  
Mohammed A. Alzunitan ◽  
Kyle E. Jenn ◽  
Michael B. Edmond ◽  
Angelique M. Dains ◽  
...  

AbstractWe performed a retrospective analysis of the impact of using the International Classification of Diseases, Tenth Revision procedure coding system (ICD-10) or current procedural terminology (CPT) codes to calculate surgical site infection (SSI) rates. Denominators and SSI rates vary depending on the coding method used. The coding method used may influence interhospital performance comparisons.

2018 ◽  
Vol 49 (1) ◽  
pp. 58-61 ◽  
Author(s):  
Joel D Handley ◽  
Hedley CA Emsley

Background: Intracranial venous thrombosis (ICVT) accounts for around 0.5% of all stroke cases. There have been no previously published studies of the International Classification of Diseases, Tenth Edition (ICD-10) validation for the identification of ICVT admissions in adults. Objective: The aims of this study were to validate and quantify the performance of the ICD-10 coding system for identifying cases of ICVT in adults and to derive an estimate of incidence. Method: Administrative data were collected for all patients admitted to a regional neurosciences centre over a 5-year period. We searched for the following ICD-10 codes at any position: G08.X (intracranial and intraspinal phlebitis and thrombophlebitis), I67.6 (non-pyogenic thrombosis of intracranial venous system), I63.6 (cerebral infarction due to cerebral venous thrombosis, non-pyogenic), O22.5 (cerebral venous thrombosis in pregnancy) and O87.3 (cerebral venous thrombosis in the puerperium). Results: Sixty-five admissions were identified by at least one of the relevant ICD-10 codes. The overall positive predictive value (PPV) for confirmed ICVT from all of the admissions combined was 92.3% (60 out of 65) with the results for each code as follows: G08.X 91.5% (54 of 59), O22.5 100% (4 of 4), I67.6 100% (1 of 1), I63.6 100% (1 of 1) and O87.3 100% (1 of 1). There were 40 unique cases of ICVT over a 5-year period giving an annual incidence of ICVT of 5 per million. Conclusions: All codes gave a high PPV. Implications for practice: As demonstrated in previous studies, the incidence of ICVT may be higher than previously thought.


2010 ◽  
Vol 31 (05) ◽  
pp. 544-547 ◽  
Author(s):  
Margaret A. Olsen ◽  
Victoria J. Fraser

We compared surveillance of surgical site infection (SSI) after major breast surgery by using a combination of International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis codes and microbiology-based surveillance. The sensitivity of the coding algorithm for identification of SSI was 87.5%, and the sensitivity of wound culture for identification of SSI was 78.1%. Our results suggest that SSI surveillance can be reliably performed using claims data.


2017 ◽  
Vol 24 (2) ◽  
pp. 157-160 ◽  
Author(s):  
Ben Beck ◽  
Christina L Ekegren ◽  
Peter Cameron ◽  
Mark Stevenson ◽  
Rodney Judson ◽  
...  

Accurate coding of injury event information is critical in developing targeted injury prevention strategies. However, little is known about the validity of the most universally used coding system, the International Classification of Diseases (ICD-10), in characterising crash counterparts in pedal cycling events. This study aimed to determine the agreement between hospital-coded ICD-10-AM (Australian modification) external cause codes with self-reported crash characteristics in a sample of pedal cyclists admitted to hospital following bicycle crashes. Interview responses from 141 injured cyclists were mapped to a single ICD-10-AM external cause code for comparison with ICD-10-AM external cause codes from hospital administrative data. The percentage of agreement was 77.3% with a κ value of 0.68 (95% CI 0.61 to 0.77), indicating substantial agreement. Nevertheless, studies reliant on ICD-10 codes from administrative data should consider the 23% level of disagreement when characterising crash counterparts in cycling crashes.


Author(s):  
Brian T. Bucher ◽  
Meng Yang ◽  
Julie Arndorfer ◽  
Cherie Frame ◽  
Jan Orton ◽  
...  

Abstract We performed a retrospective analysis of the changes in accuracy of International Classification of Diseases, Clinical Modification (ICD-CM) diagnosis codes for colectomy and hysterectomy surgical site infection surveillance. After the transition from ICD-CM ninth edition to tenth edition codes, there was no significant change in the accuracy of these codes for SSI surveillance.


2012 ◽  
Vol 51 (06) ◽  
pp. 519-528 ◽  
Author(s):  
S. Nitsuwat ◽  
W. Paoin

SummaryObjectives: The International Classification of Diseases and Related Health Problems, 10th Revision, Thai Modification (ICD-10-TM) ontology is a knowledge base created from the Thai modification of the World Health Organization International Classification of Diseases and Related Health Problems, 10th Revision. The objectives of this research were to develop the ICD-10-TM ontology as a knowledge base for use in a semi-automated ICD coding system and to test the usability of this system.Methods: ICD concepts and relations were identified from a tabular list and alphabetical indexes. An ICD-10-TM ontology was defined in the resource description framework (RDF), notation-3 (N3) format. All ICD-10-TM contents available as Microsoft Word documents were transformed into N3 format using Python scripts. Final RDF files were validated by ICD experts. The ontology was implemented as a knowledge base by using a novel semi-automated ICD coding system. Evaluation of usability was performed by a survey of forty volunteer users.Results: The ICD-10-TM ontology consists of two main knowledge bases (a tabular list knowledge base and an index knowledge base) containing a total of 309,985 concepts and 162,092 relations. The tabular list knowledge base can be divided into an upper level ontology, which defines hierarchical relationships between 22 ICD chapters, and a lower level ontology which defines relations between chapters, blocks, categories, rubrics and basic elements (include, exclude, synonym etc.)of the ICD tabular list. The index knowledge base describes relations between keywords, modifiers in general format and a table format of the ICD index. In this research, the creation of an ICD index ontology revealed interesting findings on problems with the current ICD index structure. One problem with the current structure is that it defines conditions that complicate pregnancy and perinatal conditions on the same hierarchical level as organ system diseases. This could mislead a coding algorithm into a wrong selection of ICD code. To prevent these coding errors by an algorithm, the ICD-10-TM index structure was modified by raising conditions complicating pregnancy and perinatal conditions into a higher hierarchical level of the index knowledge base. The modified ICD-10-TM ontology was implemented as a knowledge base in semi-automated ICD-10-TM coding software. A survey of users of the software revealed a high percentage of correct results obtained from ontology searches (> 95%) and user satisfaction on the usability of the ontology.Conclusion: The ICD-10-TM ontology is the first ICD-10 ontology with a comprehensive description of all concepts and relations in an ICD-10-TM tabular list and alphabetical index. A researcher developing an automated ICD coding system should be aware of The ICD index structure and the complexity of coding processes. These coding systems are not a word matching process. ICD-10 ontology should be used as a knowledge base in The ICD coding software. It can be used to facilitate successful implementation of ICD in developing countries, especially in those countries which do not have an adequate number of competent ICD coders.


2021 ◽  
Vol 8 ◽  
Author(s):  
Markus S. Jördens ◽  
Sven H. Loosen ◽  
Tobias Seraphin ◽  
Tom Luedde ◽  
Karel Kostev ◽  
...  

The COVID-19 pandemic has been a major burden for healthcare systems worldwide and has caused multiple changes and problems in outpatient care. The aim of this study was to investigate the impact of the COVID-19 pandemic on consultations and diagnoses in gastroenterology practices in Germany. To this end, we retrospectively analyzed data from the Disease Analyzer database (IQVIA) using the International Classification of Diseases, 10th revision (ICD-10). We included all patients aged ≥18 years with at least one visit to one of 48 gastroenterology practices in Germany between April and September 2019 and April and September 2020. A total of 63,914 patients in the 2nd quarter of 2019, 63,701 in the 3rd quarter of 2019, 55,769 in the 2nd quarter of 2020, and 60,446 in the 3rd quarter of 2020 were included. Overall, a clear downward trend in the number of visits to gastroenterologists was observed in the 2nd quarter of 2020 compared to 2019 (−13%, p = 0.228). The decrease in consultations was particularly pronounced in patients >70 years of age (−17%, p = 0.096). This trend was evident for all gastrointestinal diagnoses except for tumors. Most notably, rates of gastrointestinal infections (−19%) or ulcers (−43%) were significantly lower in this period than in the same quarter of 2019. Reflecting the course of the pandemic, the differences between the 3rd quarter of 2020 and that of 2019 were less pronounced (−5%, p = 0.560). Our data show that the pandemic changed patients' behavior with respect to the health care system. Using the example of German gastroenterology practices, we show that the number of consultations as well as the number and range of diagnoses have changed compared to the same period in 2019.


JAMIA Open ◽  
2019 ◽  
Vol 3 (1) ◽  
pp. 126-131 ◽  
Author(s):  
Sheila V Kusnoor ◽  
Mallory N Blasingame ◽  
Annette M Williams ◽  
Spencer J DesAutels ◽  
Jing Su ◽  
...  

Abstract Objectives The United States transitioned to the tenth version of the International Classification of Diseases (ICD) system (ICD-10) for mortality coding in 1999 and to the International Classification of Diseases, Clinical Modification and Procedure Coding System (ICD-10-CM/PCS) on October 1, 2015. The purpose of this study was to conduct a narrative literature review to better understand the impact of the implementation of ICD-10/ICD-10-CM/PCS. Materials and Methods We searched English-language articles in PubMed, Web of Science, and Business Source Complete and reviewed websites of relevant professional associations, government agencies, research groups, and ICD-10 news aggregators to identify literature on the impact of the ICD-10/ICD-10-CM/PCS transition. We used Google to search for additional gray literature and used handsearching of the references of the most on-target articles to help ensure comprehensiveness. Results Impact areas reported in the literature include: productivity and staffing, costs, reimbursement, coding accuracy, mapping between ICD versions, morbidity and mortality surveillance, and patient care. With the exception of morbidity and mortality surveillance, quantitative studies describing the actual impact of the ICD-10/ICD-10-CM/PCS implementation were limited and much of the literature was based on the ICD-10-CM/PCS transition rather than the earlier conversion to ICD-10 for mortality coding. Discussion This study revealed several gaps in the literature that limit the ability to draw reliable conclusions about the overall impact, positive or negative, of moving to ICD-10/ICD-10-CM/PCS in the United States. Conclusion These knowledge gaps present an opportunity for future research and knowledge sharing and will be important to consider when planning for ICD-11.


Author(s):  
Catherine Eastwood ◽  
Danielle Southern ◽  
Alicia Boxill ◽  
Malgorzata Maciszewski ◽  
Hude Quan ◽  
...  

IntroductionA high performing health data classification system requires clear, comprehensive code descriptions and user-friendly coding tools for effective coding. Coding specialists have essential specialized knowledge to contribute to the development and functionality of the 11th version of International Classification of Diseases (ICD-11) that will be released in June of 2018. Objectives and ApproachThe objective was to evaluate coding specialists’ experience of coding using ICD-11 for complete inpatient hospital charts. Mixed methods were employed for a survey and interviews. As part of a large field trial, 6 certified coding specialists underwent training to use the ICD-11 Beta Draft browser and ICD-11 Coding Tool. The coding team completed multiple coding exercises and coded over 60 charts each prior to evaluation of their experience. An electronic survey was used to evaluate ICD-11 knowledge, comprehension, and application of the coding training. Interviews explored the coders’ experience of learning and using the ICD-11 classification system. ResultsThe coding team (3 to 10 years of experience) received 14 hours classroom training and 5-10 hours per week of coding practice over 3 months. After training, perceived confidence in coding with ICD-11 was satisfactory; moderate (n=4), high (n=1), and low (n=1). Coding short scenarios was the most useful resource (n=6) and lack of guidelines was the most frustrating. Learning ICD-11 was deemed moderately (n=2) to somewhat (n=3) difficult but each coder described satisfaction in learning the new system. From the interviews, coders expressed liking the ability to more fully describe health conditions and hospital harms with code clusters. “The codes paint a clearer picture of what happened than with ICD-10”. With practice they achieved speed with the coding tools. Conclusion/ImplicationsCoding specialists learned and proficiently used the Beta Version of ICD-11 coding system with moderate perceived confidence. New ICD-11 codes and clustering functions allowed for more complete description of health scenarios and enhanced coder satisfaction.


Author(s):  
Timo D. Vloet ◽  
Marcel Romanos

Zusammenfassung. Hintergrund: Nach 12 Jahren Entwicklung wird die 11. Version der International Classification of Diseases (ICD-11) von der Weltgesundheitsorganisation (WHO) im Januar 2022 in Kraft treten. Methodik: Im Rahmen eines selektiven Übersichtsartikels werden die Veränderungen im Hinblick auf die Klassifikation von Angststörungen von der ICD-10 zur ICD-11 zusammenfassend dargestellt. Ergebnis: Die diagnostischen Kriterien der generalisierten Angststörung, Agoraphobie und spezifischen Phobien werden angepasst. Die ICD-11 wird auf Basis einer Lebenszeitachse neu organisiert, sodass die kindesaltersspezifischen Kategorien der ICD-10 aufgelöst werden. Die Trennungsangststörung und der selektive Mutismus werden damit den „regulären“ Angststörungen zugeordnet und können zukünftig auch im Erwachsenenalter diagnostiziert werden. Neu ist ebenso, dass verschiedene Symptomdimensionen der Angst ohne kategoriale Diagnose verschlüsselt werden können. Diskussion: Die Veränderungen im Bereich der Angsterkrankungen umfassen verschiedene Aspekte und sind in der Gesamtschau nicht unerheblich. Positiv zu bewerten ist die Einführung einer Lebenszeitachse und Parallelisierung mit dem Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Schlussfolgerungen: Die entwicklungsbezogene Neuorganisation in der ICD-11 wird auch eine verstärkte längsschnittliche Betrachtung von Angststörungen in der Klinik sowie Forschung zur Folge haben. Damit rückt insbesondere die Präventionsforschung weiter in den Fokus.


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