Improved Coding of Postoperative Deep Vein Thrombosis and Pulmonary Embolism in Administrative Data (AHRQ Patient Safety Indicator 12) After Introduction of New ICD-9-CM Diagnosis Codes

BACKGROUND:Symptomatic venous thromboembolism is a common postoperative complication. The Agency for Healthcare Research and Quality (AHRQ) has developed a Patient Safety Indicator 12 to assist hospitals, payers, and other stakeholders to identify patients who experienced this complication. OBJECTIV...

Full description

Saved in:
Bibliographic Details
Published in:Medical care 2015-05, Vol.53 (5), p.e37-e40
Main Authors: Sadeghi, Banafsheh, White, Richard H., Maynard, Gregory, Zrelak, Patricia, Strater, Amy, Hensley, Laurie, Cerese, Julie, Romano, Patrick
Format: Article
Language:English
Subjects:
Applied Methods
Clinical Coding - standards
Embolisms
Hospitals, University
Humans
International Classification of Diseases - standards
Joint surgery
Medical coding
Medical diagnosis
Patient Safety
Postoperative Complications
Pulmonary Embolism - diagnosis
Quality Indicators, Health Care
Reproducibility of Results
Retrospective Studies
Risk Factors
Thrombosis
United States
United States Agency for Healthcare Research and Quality
Venous Thromboembolism - diagnosis
Venous Thrombosis - diagnosis
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:BACKGROUND:Symptomatic venous thromboembolism is a common postoperative complication. The Agency for Healthcare Research and Quality (AHRQ) has developed a Patient Safety Indicator 12 to assist hospitals, payers, and other stakeholders to identify patients who experienced this complication. OBJECTIVES:To determine whether newly created and recently redefined ICD-9-CM codes improved the criterion validity of Patient Safety Indicator 12, based on new samples of records dated after October 2009. RESEARCH DESIGN, SUBJECTS, MEASURES:Two sources of data were used(1) UHC retrospective case-control study of risk factors for acute symptomatic venous thromboembolism occurring within 90 days after total knee arthroplasty in teaching hospitals; (2) chart abstraction data by volunteer hospitals participating in the Validation Pilot Project of the AHRQ. RESULTS:In the UHC sample, the positive predictive value (PPV) was 99% (125/126) and the negative predictive value was 99.4% (460/463). In the AHRQ sample, the overall PPV was 81% (126/156). CONCLUSIONS:The PPV based on both samples shows substantial improvement compared with the previously reported PPVs of 43%–48%, suggesting that changes in ICD-9-CM code architecture and better coding guidance can improve the usefulness of coded data.
ISSN:0025-7079
1537-1948
DOI:10.1097/MLR.0b013e318287d59e