Pbi40 Icd-9 to Icd-10 Mapping for Research in Biologics and Biosimilars Using Administrative Healthcare Data

Abstract

the Centers for Medicare and Medicaid Services (CMS) mandated the transition from ICD-9 to ICD-10 codes. Post-marketing surveillance of originator biologics and their corresponding biosimilars by the Biologics & Biosimilars Collective Intelligence Consortium (BBCIC) requires a robust approach to convert ICD-9 to ICD-10 codes used to define study variables. We examined three ICD-9 to ICD-10 mapping methods for health conditions (HCs) of BBCIC's interest and compared their incidence in BBCIC's distributed research network (DRN). Methods: We applied forward-backward mapping (FBM), using direct links of forward and backward General Equivalence Mappings developed by CMS, to 110 HCs. Secondary mapping (SM) and tertiary mapping (TM), based on iterations of FBM, were tested for 7 selected variables. A physician reviewed the mapped ICD-10 codes from the three methods. Incidence of the 110 HCs defined by ICD-9 versus ICD-10 codes was examined in the DRN during 9/1/2012-3/31/2018. We visually assessed incidence trends before and after October 2015 and used a threshold of 20% level change to examine the performance of ICD-9-to-ICD-10 conversion. Results: Nearly 4 times more ICD-10 codes were mapped by SM and TM compared to FBM. However, the additional codes identified by SM or TM were mostly irrelevant or non-specific.For distinct conditions such as myocardial infarction, SM or TM did not add any ICD-10 codes. Through visual inspection, 22% HCs had inconsistent ICD-9 versus ICD-10 trends; in general, ICD-10 algorithms led to a higher incidence. 15% HCs had an incidence level change greater than +/-20% between ICD-9 and ICD-10 algorithms. Conclusions: FBM is generally the most efficient way to convert ICD-9 to ICD-10 codes, yet manual review of converted ICD-10 codes is recommended even for FBM. No existing guidance is available to compare the performance of ICD-9 versus ICD-10 codes, leading to challenges in empirically determining the quality of conversions.

The contribution of genetic risk to the comorbidity of depression and anxiety: a multi-site electronic health records study

“…higher order group of diagnoses, as described and validated by the Phecode map 1.2b1 34 ) available from https://phewascatalog.org/phecodes. 35,36 These definitions were then modified through expert curation from the authors. Depression was defined as having at least one depression-related ICD9/10 code, using an initial list of ICD9/10 codes mapped to the phecode for depression (296.2 and 296.22), 35,36 with the addition of dysthymic disorder [ICD9:300.4; ICD10:F34.1], depressive type psychosis [ICD9:298.0], and atypical depressive disorder [ICD9:296.82].…”

“…35,36 These definitions were then modified through expert curation from the authors. Depression was defined as having at least one depression-related ICD9/10 code, using an initial list of ICD9/10 codes mapped to the phecode for depression (296.2 and 296.22), 35,36 with the addition of dysthymic disorder [ICD9:300.4; ICD10:F34.1], depressive type psychosis [ICD9:298.0], and atypical depressive disorder [ICD9:296.82]. Anxiety was defined as having at least one anxiety-related ICD9/10 code, using an initial list of ICD9/10 codes mapped to phecodes for anxiety disorders, generalized anxiety disorders, social phobias and panic disorders, and phobias (300.1, 300.11, 300.12, 300.13, respectively) 35,36 with the addition of separation anxiety disorder [ICD9: 309.21; ICD10: F93.0] and removing phobic and social anxiety disorder in childhood (ICD10: F93.1 and F93.2) as well as hysteria (ICD9: 300.1) and overanxious disorder (ICD9: 313).…”

The importance of social activity to risk of major depression in older adults

“…Participants were followed up from index date until the last follow-up date (death date, the date of first MDD diagnosis, or 6 April 2020, whichever comes first). MDD was defined based on having at least one MDD-related ICD9/10 code, using an initial list of ICD9/10 codes mapped to phecodes for MDD [296.2 and 296.22, available from https://phewascatalog.org/phecodes (He et al, 2019;Wei et al, 2017)], with minor modification [adding dysthymic disorder (ICD9:300.4), depressive type psychosis (ICD9: 298.0), and atypical depressive disorder (ICD9: 296.82)]. The complete list of ICD9/10 codes is presented in online Supplementary Table S1.…”

The genetic contribution to the comorbidity of depression and anxiety: a multi-site electronic health records study of almost 178 000 people

“…higher order group of diagnoses, as described and validated by the Phecode map 1.2b1 (Denny et al, 2010 )] available from . (He et al, 2019 ; Wei et al, 2017 ) These definitions were then modified through expert curation from the authors. Depression was defined as having at least two depression-related ICD9/10 codes, using an initial list of ICD9/10-CM codes mapped to the phecode for depression (296.2 and 296.22) (He et al, 2019 ; Wei et al, 2017 ), with the addition of dysthymic disorder [ICD9:300.4; ICD10:F34.1], depressive type psychosis [ICD9:298.0], and atypical depressive disorder [ICD9:296.82].…”

“…(He et al, 2019;Wei et al, 2017) These definitions were then modified through expert curation from the authors. Depression was defined as having at least two depression-related Psychological Medicine ICD9/10 codes, using an initial list of ICD9/10-CM codes mapped to the phecode for depression (296.2 and 296.22) (He et al, 2019;Wei et al, 2017), with the addition of dysthymic disorder [ICD9:300.4; ICD10:F34.1], depressive type psychosis [ICD9:298.0], and atypical depressive disorder [ICD9:296.82]. Anxiety was defined as having at least two anxiety-related ICD9/10 codes, using an initial list of ICD9/10-CM codes mapped to phecodes for anxiety disorders, generalized anxiety disorders, social phobias and panic disorders, and phobias (300.1, 300.11, 300.12, 300.13, respectively) (He et al, 2019;Wei et al, 2017) with the addition of separation anxiety disorder [ICD9: 309.21; ICD10: F93.0] and removing hysteria (ICD9: 300.1) and overanxious disorder (ICD9: 313).…”