Dataset Information

Pneumonia Hospitalization Coding Changes Associated With Transition From the 9th to 10th Revision of International Classification of Diseases.

ABSTRACT:

Objectives

To evaluate the impact of International Classification of Disease, 10th revision, Clinical Modification (ICD-10-CM) implementation on pneumonia hospitalizations rates, which had declined following pneumococcal conjugate vaccine introduction for infants in 2000.

Methods

We randomly selected records from a single hospital 1 year before (n = 500) and after (n = 500) October 2015 implementation of ICD-10-CM coding. We used a validated ICD-9-CM algorithm and translation of that algorithm to ICD-10-CM to identify pneumonia hospitalizations pre- and post-implementation, respectively. We recoded ICD-10-CM records to ICD-9-CM and vice versa. We calculated sensitivity and positive predictive value (PPV) of the ICD-10-CM algorithm using ICD-9-CM coding as the reference. We used sensitivity and PPV values to calculate an adjustment factor to apply to ICD-10 era rates to enable comparison with ICD-9-CM rates. We reviewed primary diagnoses of charts not meeting the pneumonia definition when recoded.

Results

Sensitivity and PPV of the ICD-10-CM algorithm were 94% and 92%, respectively, for young children and 74% and 79% for older adults. The estimated adjustment factor for ICD-10-CM period rates was -2.09% (95% credible region [CR], -7.71% to +3.0%) for children and +6.76% (95% CR, -3.06% to +16.7%) for older adults. We identified a change in coding adult charts that met the ICD-9-CM pneumonia definition that led to recoding in ICD-10-CM as chronic obstructive pulmonary disease (COPD) exacerbation.

Conclusions

The ICD-10-CM algorithm derived from a validated ICD-9-CM algorithm should not introduce substantial bias for evaluating pneumonia trends in children. However, changes in coding of pneumonia associated with COPD in adults warrant further study.

SUBMITTER: Smithee RB

PROVIDER: S-EPMC7383658 | biostudies-literature | 2020 Jan-Dec

REPOSITORIES: biostudies-literature

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Publications

Pneumonia Hospitalization Coding Changes Associated With Transition From the 9th to 10th Revision of <i>International Classification of Diseases</i>.

Smithee Ryan B RB Markus Tiffanie M TM Soda Elizabeth E Grijalva Carlos G CG Xing Wei W Shang Nong N Griffin Marie R MR Lessa Fernanda C FC

Health services research and managerial epidemiology 20200101

<h4>Objectives</h4>To evaluate the impact of <i>International Classification of Disease</i>, 10th revision, Clinical Modification (<i>ICD-10-CM</i>) implementation on pneumonia hospitalizations rates, which had declined following pneumococcal conjugate vaccine introduction for infants in 2000.<h4>Methods</h4>We randomly selected records from a single hospital 1 year before (n = 500) and after (n = 500) October 2015 implementation of <i>ICD-10-CM</i> coding. We used a validated <i>ICD-9-CM</i> al ...[more]

PMID: 32782916

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