Improved coding of postoperative deep vein thrombosis and pulmonary embolism in administrative data (AHRQ patient safety indicator 12) after introduction of new ICD-9-CM diagnosis codes

Banafsheh Sadeghi, Richard H White, Gregory Maynard, Patricia Zrelak, Amy Strater, Laurie Hensley, Julie Cerese, Patrick S Romano

Research output: Contribution to journalArticle

18 Scopus citations

Abstract

Background: Symptomatic venous thromboembolism is a common postoperative complication. The Agency for Healthcare Research and Quality (AHRQ) has developed a Patient Safety Indicator 12 to assist hospitals, payers, and other stakeholders to identify patients who experienced this complication. Objectives: To determine whether newly created and recently redefined ICD-9-CM codes improved the criterion validity of Patient Safety Indicator 12, based on new samples of records dated after October 2009. Research Design, Subjects, Measures: Two sources of data were used: (1) UHC retrospective case-control study of risk factors for acute symptomatic venous thromboembolism occurring within 90 days after total knee arthroplasty in teaching hospitals; (2) chart abstraction data by volunteer hospitals participating in the Validation Pilot Project of the AHRQ. Results: In the UHC sample, the positive predictive value (PPV) was 99% (125/126) and the negative predictive value was 99.4% (460/463). In the AHRQ sample, the overall PPV was 81% (126/156). Conclusions: The PPV based on both samples shows substantial improvement compared with the previously reported PPVs of 43%-48%, suggesting that changes in ICD-9-CM code architecture and better coding guidance can improve the usefulness of coded data.

Original languageEnglish (US)
Pages (from-to)e37-e40
JournalMedical Care
Volume53
Issue number5
DOIs
StatePublished - Apr 27 2015

Keywords

  • administrative data validation
  • AHRQ
  • post operative VTE, PSI 12
  • predictive values

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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