Changes in Classifications of Chronic Lower-Limb Wound Codes in Patients with Diabetes. (February 2015)

• Record Type: Journal Article
• Authors: Lowe, Jeanne R.; Raugi, Greg; Reiber, Gayle E.; Whitney, JoAnne D.
• Is Part Of: Advances in skin & wound care. Volume 28:Number 2(2015)
• Publication Date: 2015-02
• Subjects: Wounds and injuries -- Treatment -- Periodicals; Wound healing -- Periodicals; Skin -- Diseases -- Treatment -- Periodicals; Dermatology -- United States -- Periodicals; 617.106
• DOI: 10.1097/01.ASW.0000459576.85574.3f
• Languages: English
• ISSNs: 1527-7941

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <sec> <title>PURPOSE:</title> <p>To enhance the learner's competence with knowledge of changes in classifications of chronic lower limb wound codes from ICD-9-CM to ICD-10-CM in patients with diabetes.</p> </sec> <sec> <title>TARGET AUDIENCE:</title> <p>This continuing education activity is intended for physicians and nurses with an interest in skin and wound care.</p> </sec> <sec> <title>OBJECTIVES:</title> <p>After participating in this educational activity, the participant should be better able to:</p> <p>1. Identify the upcoming transition date and coding differences of ICD-9-CM and ICD-10-CM coding.</p> <p>2. Interpret the author's study population, methods, and design.</p> <p>3. Summarize the author's study findings comparing ICD-9-CM coding to ICD-10-CM coding.</p> </sec> <sec> <title>ABSTRACT</title> <p> <bold>OBJECTIVE:</bold>To determine the sensitivity and specificity of <italic>International Classification of Diseases, Ninth Edition, Clinical Modification</italic> (<italic>ICD-9-CM</italic>) and <italic>ICD-10-CM</italic> codes for individuals with diabetes and foot ulcers.</p> </sec> <sec> <title>DESIGN AND METHODS:</title> <p>Wound care providers and researchers are concerned about the potential impacts when the United States transitions from <italic>ICD-9-CM</italic> to <italic>ICD-10-CM</italic>. To identify the impact on diabetic foot ulcers, health history and wound variables were prospectively assessed with criterion-standard data from a prospective study of 49 patients with 65 foot ulcer episodes representing 81 incident foot ulcers. The <italic>ICD-9-CM</italic> and <italic>ICD-10-CM</italic> code sets were mapped to correctly classify individuals with diabetes and foot ulcers.</p> </sec> <sec> <title>RESULTS:</title> <p>Frequencies for health history variables were similar in both systems. The <italic>ICD-9</italic> code did not capture any data on laterality (left or right) or ulcer depth/severity. The <italic>ICD-9</italic> captured 69 of 81 incident ulcers (85%) and 94% of heel and midfoot ulcers, whereas the <italic>ICD-10</italic> code captured 78 of 81 incident ulcers (96%) and all incident heel or midfoot ulcers. Sensitivity and specificity for ulcer characteristics were consistently lower in <italic>ICD-9</italic> than in <italic>ICD-10</italic>.</p> </sec> <sec> <title>CONCLUSIONS:</title> <p>The <italic>ICD-9</italic> and <italic>ICD-10</italic> are similar for data capture on health history variables, but wound variables are captured more accurately using <italic>ICD-10</italic>. The increased specificity of <italic>ICD-10</italic> for ulcer location and severity improves identification and tracking ulcers during an episode of care.</p> </sec> </abstract>