Validity of the International Classification of Diseases, 10th revision discharge diagnosis codes for hyponatraemia in the Danish National Registry of Patients

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.

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The Validity of International Classification of Diseases, Ninth Revision, Clinical Modification Diagnosis Codes for Identifying Patients Hospitalized for COPD Exacerbations

CHEST Journal ◽

10.1378/chest.11-0024 ◽

2012 ◽

Vol 141 (1) ◽

pp. 87-93 ◽

Cited By ~ 68

Author(s):

Brian D. Stein ◽

Adriana Bautista ◽

Glen T. Schumock ◽

Todd A. Lee ◽

Jeffery T. Charbeneau ◽

...

Keyword(s):

International Classification Of Diseases ◽

International Classification ◽

Copd Exacerbations ◽

Diagnosis Codes ◽

Classification Of Diseases

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Identifying Clinically Disruptive International Classification of Diseases 10th Revision Clinical Modification Conversions to Mitigate Financial Costs Using an Online Tool

Journal of Oncology Practice ◽

10.1200/jop.2013.001156 ◽

2014 ◽

Vol 10 (2) ◽

pp. 97-103 ◽

Cited By ~ 9

Author(s):

Neeta K. Venepalli ◽

Yusuf Qamruzzaman ◽

Jianrong “John” Li ◽

Yves A. Lussier ◽

Andrew D. Boyd

Keyword(s):

Clinical Oncology ◽

International Classification Of Diseases ◽

Information Loss ◽

International Classification ◽

Online Tool ◽

Financial Costs ◽

Diagnosis Codes ◽

Classification Of Diseases ◽

Icd 10

Complex transitions and diagnosis codes associated with information loss within clinical oncology require additional attention during the transition to ICD-10-CM.

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Multicenter Study of Surveillance for Hospital-Onset Clostridium difficile Infection by the Use of ICD-9-CM Diagnosis Codes

Infection Control and Hospital Epidemiology ◽

10.1086/650447 ◽

2010 ◽

Vol 31 (3) ◽

pp. 262-268 ◽

Cited By ~ 53

Author(s):

Erik R. Dubberke ◽

Anne M. Butler ◽

Deborah S. Yokoe ◽

Jeanmarie Mayer ◽

Bala Hota ◽

...

Keyword(s):

Clostridium Difficile ◽

International Classification Of Diseases ◽

Discharge Diagnosis ◽

Linear Regression Models ◽

Diagnosis Code ◽

Diagnosis Codes ◽

Classification Of Diseases ◽

Toxin Assay ◽

Present On Admission

Objective.To compare incidence of hospital-onset Clostridium difficile infection (CDI) measured by the use of International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) discharge diagnosis codes with rates measured by the use of electronically available C. difficile toxin assay results.Methods.Cases of hospital-onset CDI were identified at 5 US hospitals during the period from July 2000 through June 2006 with the use of 2 surveillance definitions: positive toxin assay results (gold standard) and secondary ICD-9-CM discharge diagnosis codes for CDI. The x2 test was used to compare incidence, linear regression models were used to analyze trends, and the test of equality was used to compare slopes.Results.Of 8,670 cases of hospital-onset CDI, 38% were identified by the use of both toxin assay results and the ICD-9-CM code, 16% by the use of toxin assay results alone, and 45% by the use of the ICD-9-CM code alone. Nearly half (47%) of cases of CDI identified by the use of a secondary diagnosis code alone were community-onset CDI according to the results of the toxin assay. The rate of hospital-onset CDI found by use of ICD-9-CM codes was significantly higher than the rate found by use of toxin assay results overall (P<.001), as well as individually at 3 of the 5 hospitals (P<.001 for all). The agreement between toxin assay results and the presence of a secondary ICD-9-CM diagnosis code for CDI was moderate, with an overall k value of 0.509 and hospital-specific k values of 0.489–0.570. Overall, the annual increase in CDI incidence was significantly greater for rates determined by the use of ICD-9-CM codes than for rates determined by the use of toxin assay results (P = .006).Conclusions.Although the ICD-9-CM code for CDI seems to be adequate for measuring the overall CDI burden, use of the ICD-9-CM discharge diagnosis code for CDI, without present-on-admission code assignment, is not an acceptable surrogate for surveillance for hospital-onset CDI.

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The importance of nomenclature for congenital cardiac disease: implications for research and evaluation

Cardiology in the Young ◽

10.1017/s1047951108002515 ◽

2008 ◽

Vol 18 (S2) ◽

pp. 92-100 ◽

Cited By ~ 87

Author(s):

Matthew J. Strickland ◽

Tiffany J. Riehle-Colarusso ◽

Jeffrey P. Jacobs ◽

Mark D. Reller ◽

William T. Mahle ◽

...

Keyword(s):

Hypoplastic Left Heart Syndrome ◽

International Classification Of Diseases ◽

International Classification ◽

Left Heart ◽

Hypoplastic Left Heart ◽

Diagnosis Codes ◽

Congenital Cardiac Disease ◽

Classification Of Diseases ◽

Left Heart Syndrome

AbstractBackgroundAdministrative databases are often used for congenital cardiac disease research and evaluation, with little validation of the accuracy of the diagnostic codes.MethodsMetropolitan Atlanta Congenital Defects Program surveillance records were reviewed and classified using a version of the International Pediatric and Congenital Cardiac Code. Using this clinical nomenclature as the referent, we report the sensitivity and false positive fraction (1 – positive predictive value) of the International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis codes for tetralogy of Fallot, transposition of the great arteries, and hypoplastic left heart syndrome.ResultsWe identified 4918 infants and foetuses with congenital cardiac disease from the surveillance records. Using only the International Classification of Diseases diagnosis codes, there were 280 records with tetralogy, 317 records with transposition, and 192 records with hypoplastic left heart syndrome. Based on the International Pediatric and Congenital Cardiac Code, 330 records were classified as tetralogy, 163 records as transposition, and 179 records as hypoplastic left heart syndrome. The sensitivity of International Classification of Diseases diagnosis codes was 83% for tetralogy, 100% for transposition, and 95% for hypoplastic left heart syndrome. The false positive fraction was 2% for tetralogy, 49% for transposition, and 11% for hypoplastic left heart syndrome.ConclusionsAnalyses based on International Classification of Diseases diagnosis codes may have substantial misclassification of congenital heart disease. Isolating the major defect is difficult, and certain codes do not differentiate between variants that are clinically and developmentally different.

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