Translating coding lists in administrative claims-based research for cardiovascular procedures

Wanken, Zachary J.; Anderson, Peter B.; Bessen, Sarah Y.; Rode, John B.; Columbo, Jesse A.; Trooboff, Spencer W.; Moore, Kayla; Goodney, Philip P.

doi:10.1016/j.jvs.2019.09.040

Cited by 10 publications

(3 citation statements)

References 5 publications

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“…First, prior ICD-9 code lists that were derived and validated to detect stroke are not compatible with ICD-10 data. Investigators studying stroke events in Medicare claims data after 2016 can no longer use previously validated ICD-9 code lists . Second, the number of possible diagnosis codes for use has increased from approximately 13 000 codes in ICD-9 to approximately 70 000 codes in ICD-10 .…”

Section: Discussionmentioning

confidence: 99%

Derivation and Validation of ICD-10 Codes for Identifying Incident Stroke

Columbo,

Daya,

Colantonio

et al. 2024

JAMA Neurol

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ImportanceClaims data with International Statistical Classification of Diseases, Tenth Revision (ICD-10) codes are routinely used in clinical research. However, the use of ICD-10 codes to define incident stroke has not been validated against expert-adjudicated outcomes in the US population.ObjectiveTo develop and validate the accuracy of an ICD-10 code list to detect incident stroke events using Medicare inpatient fee-for-service claims data.Design, Setting, and ParticipantsThis cohort study used data from 2 prospective population-based cohort studies, the Atherosclerosis Risk in Communities (ARIC) study and the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study, and included participants aged 65 years or older without prior stroke who had linked Medicare claims data. Stroke events in the ARIC and REGARDS studies were identified via active surveillance and adjudicated by expert review. Medicare-linked ARIC data (2016-2018) were used to develop a list of ICD-10 codes for incident stroke detection. The list was validated using Medicare-linked REGARDS data (2016-2019). Data were analyzed from September 1, 2022, through September 30, 2023.ExposuresStroke events detected in Medicare claims vs expert-adjudicated stroke events in the ARIC and REGARDS studies.Main Outcomes and MeasuresThe main outcomes were sensitivity and specificity of incident stroke detection using ICD-10 codes.ResultsIn the ARIC study, there were 110 adjudicated incident stroke events among 5194 participants (mean [SD] age, 80.1 [5.3] years) over a median follow-up of 3.0 (range, 0.003-3.0) years. Most ARIC participants were women (3160 [60.8%]); 993 (19.1%) were Black and 4180 (80.5%) were White. Using the primary diagnosis code on a Medicare billing claim, the ICD-10 code list had a sensitivity of 81.8% (95% CI, 73.3%-88.5%) and a specificity of 99.1% (95% CI, 98.8%-99.3%) to detect incident stroke. Using any diagnosis code on a Medicare billing claim, the sensitivity was 94.5% (95% CI, 88.5%-98.0%) and the specificity was 98.4% (95% CI, 98.0%-98.8%). In the REGARDS study, there were 140 adjudicated incident strokes among 6359 participants (mean [SD] age, 75.8 [7.0] years) over a median follow-up of 4.0 (range, 0-4.0) years. More than half of the REGARDS participants were women (3351 [52.7%]); 1774 (27.9%) were Black and 4585 (72.1%) were White. For the primary diagnosis code, the ICD-10 code list had a sensitivity of 70.7% (95% CI, 63.2%-78.3%) and a specificity of 99.1% (95% CI, 98.9%-99.4%). For any diagnosis code, the ICD-10 code list had a sensitivity of 77.9% (95% CI, 71.0%-84.7%) and a specificity of 98.9% (95% CI, 98.6%-99.2%).Conclusions and RelevanceThese findings suggest that ICD-10 codes could be used to identify incident stroke events in Medicare claims with moderate sensitivity and high specificity.

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Section: Discussionmentioning

confidence: 99%

Derivation and Validation of ICD-10 Codes for Identifying Incident Stroke

Columbo,

Daya,

Colantonio

et al. 2024

JAMA Neurol

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“…This decrease in SMM is primarily due to the decreased incidence of blood transfusion codes. In addition, direct translations for diagnosis and procedure codes are rare between these code systems (25). The transition from ICD-9-CM to ICD-10-CM and ICD-10-PCS could impact the results of this study because both code systems were used to identify delivery hospitalizations and SMM indicators.…”

Section: Discussionmentioning

confidence: 99%

National Hospital Care Survey Demonstration Projects: Severe Maternal Morbidity in Inpatient and Emergency Departments

Alford¹,

Williams²,

Oriaku³

et al. 2021

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“…We have previously described a framework whereby investigators could derive lists of ICD-9 and ICD-10 codes to use in outcome identification in claims-based analyses. 11 The framework follows an iterative process requiring the following: A research question with an exposure and outcome A compendium of ICD-9 and ICD-10 codes A claims-based data source in which to apply the codes One, or ideally two, clinical reviewers …”

Section: Methodsmentioning

confidence: 99%