Use of Medicare Diagnosis and Procedure Codes to Improve Detection of Surgical Site Infections following Hip Arthroplasty, Knee Arthroplasty, and Vascular Surgery

Abstract

S.; and CDC Prevention Epicenters Program, ,"Use of Medicare diagnosis and procedure codes to improve detection of surgical site infections following hip arthroplasty, knee arthroplasty, and vascular surgery

Medicare Claims Can Be Used to Identify US Hospitals With Higher Rates of Surgical Site Infection Following Vascular Surgery

“…This was based on the high sensitivity of the selected SSI codes in prior work. 5,6 The high sensitivity of claims for detecting SSI is also supported by a recent meta-analysis. 43 Still, it is possible that some patients who develop an SSI might not be identified by this approach.…”

“…The vascular surgery and SSI codes (Appendix 1) are similar to a previous pilot study. 6,13 To avoid uncertainty in attributing an SSI to a specific procedure, we excluded patients who underwent another major surgery within 60 days before vascular surgery. 13 We also excluded patients with multiple surgical dates for vascular surgery during their index hospitalization.…”

“…5,6,[22][23][24][25][26][27][28][29][30] This strategy is being used by hospitals and state SSI programs to improve reporting, 26,29,30 and by CMS during validation survey.…”

“…Although traditional surveillance detected SSIs following 4.4% of vascular procedures, claims-based surveillance detected SSIs following 7.9% of vascular procedures, with 1 SSI confirmed for every 2 cases reviewed. 6 This compares to an average of 16 cases reviewed by infection control personnel for every SSI confirmed using traditional surveillance methods. 6 The aim of the current study was to validate the use of diagnosis and procedure codes in claims data as a surrogate marker of SSI following vascular surgery among fee-for-service Medicare enrollees aged 65 years and older in US acute care hospitals.…”

Methodology of the Norwegian Surveillance System for Healthcare-Associated Infections: The value of a mandatory system, automated data collection, and active postdischarge surveillance

“…Although traditional case-finding by ICPs has been considered the "gold standard" of HAI surveillance, several newer studies show that this is not necessarily the case: computer-aided surveillance may be more time-efficient and superior in case-finding. Many studies have compared traditional surveillance by ICPs with case-finding using surveillance definitions to available data sources such as ICD-9 diagnostic codes and other administrative coding; 78,81,87,89,[177][178][179][180][181] microbiology, laboratory or pharmacy data; [182][183][184][185] or a combination of these 84,137,146,184,[186][187][188][189] . Some have utilized advanced algorithms to detect SSIs and validate these against ICP case-finding.…”