scholarly journals Estimated Burden of Methicillin-Resistant Staphylococcus aureus in California Hospitals after Changes to Administrative Codes, 2005–2010

2013 ◽  
Vol 34 (11) ◽  
pp. 1218-1221 ◽  
Author(s):  
David M. Tehrani ◽  
Chenghua Cao ◽  
Homin Kwark ◽  
Susan S. Huang
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
International Classification Of Diseases ◽  
International Classification ◽  
Methicillin Resistant ◽  
Classification Of Diseases ◽  
The Impact

We assess the impact of revised International Classification of Diseases, Ninth Revision, codes on methicillin-resistant Staphylococcus aureus burden in California hospitals. Codes were rapidly adopted, demonstrating new capture of colonization and continued relatively stable capture of infections. Nevertheless, despite new colonization codes, coded data demonstrated poor retention between serial hospitalizations.

Evaluation of International Classification of Diseases, Ninth Revision, Clinical Modification Codes for Reporting Methicillin-Resistant Staphylococcus aureus Infections at a Hospital in Illinois

2010 ◽  
Vol 31 (05) ◽  
pp. 463-468 ◽  
Author(s):  
Melissa K. Schaefer ◽  
Katherine Ellingson ◽  
Craig Conover ◽  
Alicia E. Genisca ◽  
Donna Currie ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
International Classification Of Diseases ◽  
International Classification ◽  
Care Hospital ◽  
Methicillin Resistant ◽  
Diagnosis Codes ◽  
Classification Of Diseases ◽  
Mrsa Infection ◽  
Healthcare Associated

Background. States, including Illinois, have passed legislation mandating the use of International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes for reporting healthcare-associated infections, such as methicillin-resistant Staphylococcus aureus (MRSA). Objective. To evaluate the sensitivity of ICD-9-CM code combinations for detection of MRSA infection and to understand implications for reporting. Methods. We reviewed discharge and microbiology databases from July through August of 2005, 2006, and 2007 for ICD-9-CM codes or microbiology results suggesting MRSA infection at a tertiary care hospital near Chicago, Illinois. Medical records were reviewed to confirm MRSA infection. Time from admission to first positive MRSA culture result was evaluated to identify hospital-onset MRSA (HO-MRSA) infections. The sensitivity of MRSA code combinations for detecting confirmed MRSA infections was calculated using all codes present in the discharge record (up to 15); the effect of reviewing only 9 diagnosis codes, the number reported to the Centers for Medicare and Medicaid Services, was also evaluated. The sensitivity of the combination of diagnosis codes for detection of HO-MRSA infections was compared with that for community-onset MRSA (CO-MRSA) infections. Results. We identified 571 potential MRSA infections with the use of screening criteria; 403 (71%) were confirmed MRSA infections, of which 61 (15%) were classified as HO-MRSA. The sensitivity of MRSA code combinations was 59% for all confirmed MRSA infections when 15 diagnoses were reviewed compared with 31% if only 9 diagnoses were reviewed (P < .001). The sensitivity of code combinations was 33% for HO-MRSA infections compared with 62% for CO-MRSA infections (P < .001). Conclusions. Limiting analysis to 9 diagnosis codes resulted in low sensitivity. Furthermore, code combinations were better at revealing CO-MRSA infections than HO-MRSA infections. These limitations could compromise the validity of ICD-9-CM codes for interfacility comparisons and for reporting of healthcare-associated MRSA infections.

scholarly journals Performance of Cancer Recurrence Algorithms After Coding Scheme Switch From International Classification of Diseases 9th Revision to International Classification of Diseases 10th Revision

2019 ◽  
pp. 1-9 ◽  
Author(s):  
Nikki M. Carroll ◽  
Debra P. Ritzwoller ◽  
Matthew P. Banegas ◽  
Maureen O’Keeffe-Rosetti ◽  
Angel M. Cronin ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Performance Measures ◽  
Cancer Recurrence ◽  
International Classification Of Diseases ◽  
International Classification ◽  
Receiver Operating Curve ◽  
Classification Of Diseases ◽  
The Impact ◽  
Receiver Operating

PURPOSE We previously developed and validated informatic algorithms that used International Classification of Diseases 9th revision (ICD9)–based diagnostic and procedure codes to detect the presence and timing of cancer recurrence (the RECUR Algorithms). In 2015, ICD10 replaced ICD9 as the worldwide coding standard. To understand the impact of this transition, we evaluated the performance of the RECUR Algorithms after incorporating ICD10 codes. METHODS Using publicly available translation tables along with clinician and other expertise, we updated the algorithms to include ICD10 codes as additional input variables. We evaluated the performance of the algorithms using gold standard recurrence measures associated with a contemporary cohort of patients with stage I to III breast, colorectal, and lung (excluding IIIB) cancer and derived performance measures, including the area under the receiver operating curve, average absolute prediction error, and correct classification rate. These values were compared with the performance measures derived from the validation of the original algorithms. RESULTS A total of 659 colorectal, 280 lung, and 2,053 breast cancer cases were identified. Area under the receiver operating curve derived from the updated algorithms was 89.0% (95% CI, 82.3% to 95.7%), 88.9% (95% CI, 79.3% to 98.2%), and 80.5% (95% CI, 72.8% to 88.2%) for the colorectal, lung, and breast cancer algorithms, respectively. Average absolute prediction errors for recurrence timing were 2.7 (SE, 11.3%), 2.4 (SE, 10.4%), and 5.6 months (SE, 21.8%), respectively, and timing estimates were within 6 months of actual recurrence for more than 80% of colorectal, more than 90% of lung, and more than 50% of breast cancer cases using the updated algorithm. CONCLUSION Performance measures derived from the updated and original algorithms had overlapping confidence intervals, suggesting that the ICD9 to ICD10 transition did not affect the RECUR Algorithm performance.

Predictive Ability of Positive Clinical Culture Results and International Classification of Diseases, Ninth Revision, to Identify and Classify Noninvasive Staphylococcus aureus Infections: A Validation Study

2010 ◽  
Vol 31 (07) ◽  
pp. 694-700 ◽  
Author(s):  
LaRee A. Tracy ◽  
Jon P. Furuno ◽  
Anthony D. Harris ◽  
Mary Singer ◽  
Patricia Langenberg ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Confidence Interval ◽  
Predictive Value ◽  
Positive Culture ◽  
International Classification Of Diseases ◽  
International Classification ◽  
Clinical Culture ◽  
Classification Of Diseases ◽  
Definition Of

Objective.To develop and validate an algorithm to identify and classify noninvasive infections due toStaphylococcus aureusby using positive clinical culture results and administrative data.Design.Retrospective cohort study.Setting.Veterans Affairs Maryland Health Care System.Methods.Data were collected retrospectively on allS. aureusclinical culture results from samples obtained from nonsterile body sites during October 1998 through September 2008 and associated administrative claims records. An algorithm was developed to identify noninvasive infections on the basis of a uniqueS. aureus-positive culture result from a nonsterile site sample with a matchingInternational Classification of Diseases, Ninth Revision (ICD-9-CM), code for infection at time of sampling. Medical records of a subset of cases were reviewed to find the proportion of true noninvasive infections (cases that met the Centers for Disease Control and Prevention National Healthcare Safety Network [NHSN] definition of infection). Positive predictive value (PPV) and negative predictive value (NPV) were calculated for all infections and according to body site of infection.Results.We identified 4,621 uniqueS. aureus-positive culture results, of which 2,816 (60.9%) results met our algorithm definition of noninvasiveS. aureusinfection and 1,805 (39.1%) results lacked a matchingICD-9-CMcode. Among 96 cases that met our algorithm criteria for noninvasiveS. aureusinfection, 76 also met the NHSN criteria (PPV, 79.2% [95% confidence interval, 70.0%–86.1%]). Among 98 cases that failed to meet the algorithm criteria, 80 did not meet the NHSN criteria (NPV, 81.6% [95% confidence interval, 72.8%–88.0%]). The PPV of all culture results was 55.4%. The algorithm was most predictive for skin and soft-tissue infections and bone and joint infections.Conclusion.When culture-based surveillance methods are used, the addition of administrativeICD-9-CMcodes for infection can increase the PPV of true noninvasiveS. aureusinfection over the use of positive culture results alone.

scholarly journals Predictive Ability of Positive Clinical Culture Results and International Classification of Diseases, Ninth Revision, to Identify and Classify Noninvasive Staphylococcus aureus Infections: A Validation Study

2010 ◽  
Vol 31 (7) ◽  
pp. 694-700 ◽  
Author(s):  
LaRee A. Tracy ◽  
Jon P. Furuno ◽  
Anthony D. Harris ◽  
Mary Singer ◽  
Patricia Langenberg ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Confidence Interval ◽  
Predictive Value ◽  
Positive Culture ◽  
International Classification Of Diseases ◽  
International Classification ◽  
Clinical Culture ◽  
Classification Of Diseases ◽  
Definition Of

Objective.To develop and validate an algorithm to identify and classify noninvasive infections due to Staphylococcus aureus by using positive clinical culture results and administrative data.Design.Retrospective cohort study.Setting.Veterans Affairs Maryland Health Care System.Methods.Data were collected retrospectively on all S. aureus clinical culture results from samples obtained from nonsterile body sites during October 1998 through September 2008 and associated administrative claims records. An algorithm was developed to identify noninvasive infections on the basis of a unique S. aureus-positive culture result from a nonsterile site sample with a matching International Classification of Diseases, Ninth Revision (ICD-9-CM), code for infection at time of sampling. Medical records of a subset of cases were reviewed to find the proportion of true noninvasive infections (cases that met the Centers for Disease Control and Prevention National Healthcare Safety Network [NHSN] definition of infection). Positive predictive value (PPV) and negative predictive value (NPV) were calculated for all infections and according to body site of infection.Results.We identified 4,621 unique S. aureus-positive culture results, of which 2,816 (60.9%) results met our algorithm definition of noninvasive S. aureus infection and 1,805 (39.1%) results lacked a matching ICD-9-CM code. Among 96 cases that met our algorithm criteria for noninvasive S. aureus infection, 76 also met the NHSN criteria (PPV, 79.2% [95% confidence interval, 70.0%–86.1%]). Among 98 cases that failed to meet the algorithm criteria, 80 did not meet the NHSN criteria (NPV, 81.6% [95% confidence interval, 72.8%–88.0%]). The PPV of all culture results was 55.4%. The algorithm was most predictive for skin and soft-tissue infections and bone and joint infections.Conclusion.When culture-based surveillance methods are used, the addition of administrative ICD-9-CM codes for infection can increase the PPV of true noninvasive S. aureus infection over the use of positive culture results alone.

scholarly journals A narrative review of the impact of the transition to ICD-10 and ICD-10-CM/PCS

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 ◽  
...  
Keyword(s):  
United States ◽  
International Classification Of Diseases ◽  
The United States ◽  
International Classification ◽  
Morbidity And Mortality ◽  
Classification Of Diseases ◽  
Icd 10 ◽  
The Impact ◽  
Mortality Surveillance

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.

scholarly journals Leveraging unstructured data to identify hereditary angioedema patients in electronic medical records

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Emily S. Brouwer ◽  
Emily W. Bratton ◽  
Aimee M. Near ◽  
Lynn Sanders ◽  
Christina D. Mack
Keyword(s):  
Hereditary Angioedema ◽  
Retrospective Studies ◽  
False Positive Rate ◽  
International Classification Of Diseases ◽  
International Classification ◽  
Unstructured Data ◽  
Diagnostic Coding ◽  
Classification Of Diseases ◽  
The Impact

Abstract Background The epidemiologic impact of hereditary angioedema (HAE) is difficult to quantify, due to misclassification in retrospective studies resulting from non-specific diagnostic coding. The aim of this study was to identify cohorts of patients with HAE-1/2 by evaluating structured and unstructured data in a US ambulatory electronic medical record (EMR) database. Methods A retrospective feasibility study was performed using the GE Centricity EMR Database (2006–2017). Patients with ≥ 1 diagnosis code for HAE-1/2 (International Classification of Diseases, Ninth Revision, Clinical Modification 277.6 or International Classification of Diseases, Tenth Revision, Clinical Modification D84.1) and/or ≥ 1 physician note regarding HAE-1/2 and ≥ 6 months’ data before and after the earliest code or note (index date) were included. Two mutually exclusive cohorts were created: probable HAE (≥ 2 codes or ≥ 2 notes on separate days) and suspected HAE (only 1 code or note). The impact of manually reviewing physician notes on cohort formation was assessed, and demographic and clinical characteristics of the 2 final cohorts were described. Results Initially, 1691 patients were identified: 190 and 1501 in the probable and suspected HAE cohorts, respectively. After physician note review, the confirmed HAE cohort comprised 254 patients and the suspected HAE cohort decreased to 1299 patients; 138 patients were determined not to have HAE and were excluded. The overall false-positive rate for the initial algorithms was 8.2%. Across final cohorts, the median age was 50 years and > 60% of patients were female. HAE-specific prescriptions were identified for 31% and 2% of the confirmed and suspected HAE cohorts, respectively. Conclusions Unstructured EMR data can provide valuable information for identifying patients with HAE-1/2. Further research is needed to develop algorithms for more representative HAE cohorts in retrospective studies.

scholarly journals The International Classification of Impairments, Disabilities, and Handicaps: A Mental Health Perspective

1995 ◽  
Vol 7 (1) ◽  
pp. 3-7
Author(s):  
Karen Ritchie
Keyword(s):  
Mental Health ◽  
International Classification Of Diseases ◽  
International Classification ◽  
World Health ◽  
Important Place ◽  
The World ◽  
Classification Of Diseases ◽  
Health Organization ◽  
The Impact

The International Classification of Impairments, Disabilities, and Handicaps (the ICIDH) was developed in the 1970s as an extension of the World Health Organization's International Classification of Diseases (ICD). It was developed principally to meet the criticisms of ICD users who thought that the ICD (a) did not sufficiently cover the impact of a given disease on an individual and the society in which he or she lived, and (b) was unable to describe the heterogeneity of the clinical expression of a disorder and the disorder's variable evolution in different individuals and societies. The ICIDH was first published by the World Health Organization (WHO) in 1980 and is currently undergoing its first major revision. In this revision process, psychiatry is being given an important place in response to complaints of users that the ICIDH presently has limited application in the mental health field. In a brief discussion here, I would like to describe the role of the ICIDH in relation to mental health—and to psychogeriatrics in particular—drawing on a number of debates in which I have been involved over the past few years.

Angststörungen – von der ICD-10 zur ICD-11

2020 ◽  
pp. 1-5
Author(s):  
Timo D. Vloet ◽  
Marcel Romanos
Keyword(s):  
Mental Disorders ◽  
International Classification Of Diseases ◽  
International Classification ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Dsm 5 ◽  
Classification Of Diseases ◽  
Icd 10

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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