ICD-9-CM codes poorly indentified venous thromboembolism during pregnancy

Richard H White, Leslea A. Brickner, Kate A. Scannell

Research output: Contribution to journalArticle

65 Citations (Scopus)

Abstract

Objective There is little data regarding the accuracy of pregnancy-specific ICD-9-CM codes used to identify patients with venous thromboembolism (VTE). Study design and setting We identified a large cohort of pregnant patients in whom there were one or more pregnancy-specific (600 codes) or standard ICD-9-CM codes (400 codes) for VTE. Charts of these cases were abstracted to determine the presence of objectively documented VTE. Results A total of 214 cases had a code for VTE either during pregnancy or the 6-week postpartum period; 82% had a pregnancy-specific code and 18% a standard code. Overall, 84 (39%, 95% CI=33-46%) had objectively documented VTE. A pregnancy-specific ICD-9-CM for VTE had a positive predictive value (PPV) of 54/174=31% (95% CI=24-38%), whereas standard VTE codes had a PPV of 30 of 38=80% (95% CI=63-99%). A PPV in the range of 95-100% could be attained using other criteria, at the expense of detecting only 28 to 45% of all VTE cases. Conclusions Pregnancy-specific ICD-9-CM codes for VTE have low PPV. Other criteria must be applied to select cases with a high probability of having objectively documented VTE.

Original languageEnglish (US)
Pages (from-to)985-988
Number of pages4
JournalJournal of Clinical Epidemiology
Volume57
Issue number9
DOIs
StatePublished - Sep 2004

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Venous Thromboembolism
International Classification of Diseases
Pregnancy
Postpartum Period

Keywords

  • Administrative data
  • Epidemiology
  • Pregnancy
  • Septic pelvic thrombophlebitis
  • Thromboembolism
  • Venous thrombosis

ASJC Scopus subject areas

  • Medicine(all)
  • Public Health, Environmental and Occupational Health
  • Epidemiology

Cite this

ICD-9-CM codes poorly indentified venous thromboembolism during pregnancy. / White, Richard H; Brickner, Leslea A.; Scannell, Kate A.

In: Journal of Clinical Epidemiology, Vol. 57, No. 9, 09.2004, p. 985-988.

Research output: Contribution to journalArticle

White, Richard H ; Brickner, Leslea A. ; Scannell, Kate A. / ICD-9-CM codes poorly indentified venous thromboembolism during pregnancy. In: Journal of Clinical Epidemiology. 2004 ; Vol. 57, No. 9. pp. 985-988.
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N2 - Objective There is little data regarding the accuracy of pregnancy-specific ICD-9-CM codes used to identify patients with venous thromboembolism (VTE). Study design and setting We identified a large cohort of pregnant patients in whom there were one or more pregnancy-specific (600 codes) or standard ICD-9-CM codes (400 codes) for VTE. Charts of these cases were abstracted to determine the presence of objectively documented VTE. Results A total of 214 cases had a code for VTE either during pregnancy or the 6-week postpartum period; 82% had a pregnancy-specific code and 18% a standard code. Overall, 84 (39%, 95% CI=33-46%) had objectively documented VTE. A pregnancy-specific ICD-9-CM for VTE had a positive predictive value (PPV) of 54/174=31% (95% CI=24-38%), whereas standard VTE codes had a PPV of 30 of 38=80% (95% CI=63-99%). A PPV in the range of 95-100% could be attained using other criteria, at the expense of detecting only 28 to 45% of all VTE cases. Conclusions Pregnancy-specific ICD-9-CM codes for VTE have low PPV. Other criteria must be applied to select cases with a high probability of having objectively documented VTE.

AB - Objective There is little data regarding the accuracy of pregnancy-specific ICD-9-CM codes used to identify patients with venous thromboembolism (VTE). Study design and setting We identified a large cohort of pregnant patients in whom there were one or more pregnancy-specific (600 codes) or standard ICD-9-CM codes (400 codes) for VTE. Charts of these cases were abstracted to determine the presence of objectively documented VTE. Results A total of 214 cases had a code for VTE either during pregnancy or the 6-week postpartum period; 82% had a pregnancy-specific code and 18% a standard code. Overall, 84 (39%, 95% CI=33-46%) had objectively documented VTE. A pregnancy-specific ICD-9-CM for VTE had a positive predictive value (PPV) of 54/174=31% (95% CI=24-38%), whereas standard VTE codes had a PPV of 30 of 38=80% (95% CI=63-99%). A PPV in the range of 95-100% could be attained using other criteria, at the expense of detecting only 28 to 45% of all VTE cases. Conclusions Pregnancy-specific ICD-9-CM codes for VTE have low PPV. Other criteria must be applied to select cases with a high probability of having objectively documented VTE.

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