Temporal Trends in Unstable Angina Diagnosis Codes for Outpatient Percutaneous Coronary Interventions

Abstract

Search trends are only proxies for engagement, and sentinel surveillance (such as surveys) will clarify these early findings. However, our findings demonstrate the power of grassroots movements to respond to large-scale public health crises. These results suggest that #MeToo may have reduced the stigma of sexual harassment and/or assault as more seek help. 5 Public health investments in preventing sexual harassment and/or assault is disproportionately small compared with the scale of the problem, 6 in part because the problem is hidden from the public. With millions more persons than ever voicing their needs months after #MeToo began, public health leaders should respond by investing in enhanced prevention training and improving resources for survivors.

Physician code creep after the initiation of outpatient volume control program and implications for appropriate ICD-10-CM coding

“…The findings of this study support three out of the four hypotheses we proposed (i.e., prominent decline in [7][8][9][10][11][12]. Using the Truven MarketScan data, one study indicated that the proportion of patients coded as having higher anesthesia risks increased from 11.6% in 2005 to 18.9% in 2013 for outpatient gastrointestinal endoscopy procedures [11].…”

“…A study used the Healthcare Cost and Utilization Project state databases also revealed that the proportion of outpatient percutaneous coronary interventions coded for acute indications increased prominently in New York (from 0.6% in 2010 to 8.3% in 2014), and the increase was due to a substantial rise in the number of coded unstable angina after the appropriate use criteria for coronary revascularization were released in 2009. The authors suggested the possibility of physicians increasingly classifying patients with stable chest pain as unstable angina in the outpatient setting [12].…”

“…Early studies have specifically focused on DRG creep and revealed that this acquired disease existed in numerous hospitals [2][3][4][5][6]. Subsequent studies have suggested that various types of physician code creep behaviors occurred after the introduction of value-based programs [7][8][9][10][11][12][13][14][15][16][17][18]. However, most studies on physician code creep have focused on episodes (outpatient procedures or inpatient hospitalizations) in which it was difficult to evaluate whether the increase in the use of more severe codes was due to an increase in the severity of the patient's case or to a change in the physician's coding behavior per se.…”

Association between Post-Diagnosis Particulate Matter Exposure among 5-Year Cancer Survivors and Cardiovascular Disease Risk in Three Metropolitan Areas from South Korea

“…Second, operationally defined CVD may be incorrectly coded. Unstable angina is one of the most up-coded conditions [52], and there is also the possibility that patients with multiple CVD could be down-coded should the doctor not have recorded all ICD codes for multiple complex conditions. However, the operational diagnosis was validated and had been widely used in previous studies [53,54].…”

Upcoding of Clinical Information to Meet Appropriate Use Criteria for Percutaneous Coronary Intervention

“…The benign end of the spectrum exists because the boundary between diagnostic categories is blurred, with many patients fitting two or more categories. A similar analysis has identified a dramatic rise in the volume of outpatient PCI that was categorised as 'acute' following AUC 10 . The National Cardiovascular Data Registry provides an undemanding definition of 'unstable angina' which is simple to fulfil 11 .…”