Validation of ICD-10-CM surveillance codes for traumatic brain injury inpatient hospitalizations. (5th December 2020)

• Record Type: Journal Article
• Authors: Warwick, James; Slavova, Svetla; Bush, Joshua; Costich, Julia
• Is Part Of: Brain injury. Volume 34:Number 13/14(2020)
• Page Start: 1763
• Page End: 1770
• Publication Date: 2020-12-05
• Subjects: Surveillance definition -- traumatic brain injury -- positive predictive value -- ICD-10-CM -- medical record review; Brain damage -- Periodicals; Brain -- Wounds and injuries -- Periodicals; Brain Injuries -- Periodicals; 617.481
• DOI: 10.1080/02699052.2020.1849801
• Languages: English
• ISSNs: 0269-9052

Abstract

ABSTRACT: Objective : Using inpatient data from a 1, 160-bed health system, we assessed the positive predictive value (PPV) of ICD-10-CM (International Classification of Diseases, Tenth Revision, Clinical Modification) codes included in a traumatic brain injury (TBI) surveillance definition proposed by the Centers for Disease Control and Prevention (CDC) in 2016. Methods : A random sample of 196 records with ICD-10-CM TBI codes was reviewed. The PPVs for the ICD-10-CM codes' ability to capture true TBI cases were calculated as the percentage of records with confirmed clinical provider-documented TBI and reported with 95% confidence intervals [95%CIs]. Results : The estimated overall PPV was 74% [67.9%, 80.1%] when the codes were listed in any diagnostic field, but 91.5% [86.2%, 96.8%] when listed as the principal diagnosis. S06 codes (intracranial injury) had an overall PPV of 80.2% [74.3%, 86.1%] and 96.9% [93.3%, 100%] when listed as the principal diagnosis. S02.0-.1 codes (vault/base skull fractures) in any position without co-existing S06 codes had a PPV of 15.8% [0%, 33.2%]. Conclusions : Intracranial injury codes (S06) in any diagnostic position had a very high estimated PPV. Further research is needed to determine the utility of other codes included in the CDC proposed definition for TBI surveillance.