Spine coding transition from ICD-9 to ICD-10: Not taking advantage of the specificity of a more granular system

Background: The transition from International Classification of Diseases, 9th Edition (ICD-9) to the 10th edition (ICD-10) in 2015 increased the number and specificity of diagnostic codes with the goal of facilitating clinical care and research possibilities.Considering the potential to default to l...

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Main Authors: Matthew J. Sabatino, Patrick J. Burroughs, Harold G. Moore, Jonathan N. Grauer
Format: Article
Language:English
Published: Elsevier 2020-12-01
Series:North American Spine Society Journal
Subjects:
ICD
Online Access:http://www.sciencedirect.com/science/article/pii/S2666548420300354
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spelling doaj-ededd3f143444868ba37edab26326cd92021-06-08T04:43:58ZengElsevierNorth American Spine Society Journal2666-54842020-12-014100035Spine coding transition from ICD-9 to ICD-10: Not taking advantage of the specificity of a more granular systemMatthew J. Sabatino0Patrick J. Burroughs1Harold G. Moore2Jonathan N. Grauer3Corresponding author.; Department of Orthopaedics and Rehabilitation, Yale School of Medicine, 47 College Street, New Haven, CT 06510, United StatesDepartment of Orthopaedics and Rehabilitation, Yale School of Medicine, 47 College Street, New Haven, CT 06510, United StatesDepartment of Orthopaedics and Rehabilitation, Yale School of Medicine, 47 College Street, New Haven, CT 06510, United StatesDepartment of Orthopaedics and Rehabilitation, Yale School of Medicine, 47 College Street, New Haven, CT 06510, United StatesBackground: The transition from International Classification of Diseases, 9th Edition (ICD-9) to the 10th edition (ICD-10) in 2015 increased the number and specificity of diagnostic codes with the goal of facilitating clinical care and research possibilities.Considering the potential to default to less specified ICD-10 codes, the current study evaluated the number of codes utilized for spine-related conditions before versus after the transition to ICD-10. Methods: The numbers of patients with an index encounter for a primary spine-related non-deformity diagnosis codes indexed as “dorsopathies” were abstracted from the Humana PearlDiver dataset. As the transition from ICD-9 to ICD-10 occurred in 2015, the current study compared the year prior (ICD-9) to the year after (ICD-10). The number of ICD-9 and ICD-10 codes was assessed, and distribution of utilization was compared using the Kolmogorov-Smirnov test. Results:: In 2014, 848,623 patients were assigned one of the 100 unique ICD-9 dorsopathy codes, of which 17 codes (17% of available codes) were used for more than 1% of the patients. In 2016, 840,310 patients were assigned one of the 504 unique ICD-10 dorsopathy codes, of which 21 (4% of available codes) were used for more than 1% of the patients. The top 20 codes in 2014 (ICD-9) and the top 20 codes in 2016 (ICD-10) both represented the majority of the patient population and were not statistically differently represented (p = 0.819). Further, analysis of ICD-10 codes demonstrated a clear bias toward utilizing less specified codes. Conclusions: Despite a five-fold increase in available diagnostic codes for spine conditions in ICD-10, in the year after implementation providers continued to select a small proportion of less specific diagnostic codes when treating spine patients.http://www.sciencedirect.com/science/article/pii/S2666548420300354SpineClinical codingInternational classification of diseasesCodesICDICD-9-CM
collection DOAJ
language English
format Article
sources DOAJ
author Matthew J. Sabatino
Patrick J. Burroughs
Harold G. Moore
Jonathan N. Grauer
spellingShingle Matthew J. Sabatino
Patrick J. Burroughs
Harold G. Moore
Jonathan N. Grauer
Spine coding transition from ICD-9 to ICD-10: Not taking advantage of the specificity of a more granular system
North American Spine Society Journal
Spine
Clinical coding
International classification of diseases
Codes
ICD
ICD-9-CM
author_facet Matthew J. Sabatino
Patrick J. Burroughs
Harold G. Moore
Jonathan N. Grauer
author_sort Matthew J. Sabatino
title Spine coding transition from ICD-9 to ICD-10: Not taking advantage of the specificity of a more granular system
title_short Spine coding transition from ICD-9 to ICD-10: Not taking advantage of the specificity of a more granular system
title_full Spine coding transition from ICD-9 to ICD-10: Not taking advantage of the specificity of a more granular system
title_fullStr Spine coding transition from ICD-9 to ICD-10: Not taking advantage of the specificity of a more granular system
title_full_unstemmed Spine coding transition from ICD-9 to ICD-10: Not taking advantage of the specificity of a more granular system
title_sort spine coding transition from icd-9 to icd-10: not taking advantage of the specificity of a more granular system
publisher Elsevier
series North American Spine Society Journal
issn 2666-5484
publishDate 2020-12-01
description Background: The transition from International Classification of Diseases, 9th Edition (ICD-9) to the 10th edition (ICD-10) in 2015 increased the number and specificity of diagnostic codes with the goal of facilitating clinical care and research possibilities.Considering the potential to default to less specified ICD-10 codes, the current study evaluated the number of codes utilized for spine-related conditions before versus after the transition to ICD-10. Methods: The numbers of patients with an index encounter for a primary spine-related non-deformity diagnosis codes indexed as “dorsopathies” were abstracted from the Humana PearlDiver dataset. As the transition from ICD-9 to ICD-10 occurred in 2015, the current study compared the year prior (ICD-9) to the year after (ICD-10). The number of ICD-9 and ICD-10 codes was assessed, and distribution of utilization was compared using the Kolmogorov-Smirnov test. Results:: In 2014, 848,623 patients were assigned one of the 100 unique ICD-9 dorsopathy codes, of which 17 codes (17% of available codes) were used for more than 1% of the patients. In 2016, 840,310 patients were assigned one of the 504 unique ICD-10 dorsopathy codes, of which 21 (4% of available codes) were used for more than 1% of the patients. The top 20 codes in 2014 (ICD-9) and the top 20 codes in 2016 (ICD-10) both represented the majority of the patient population and were not statistically differently represented (p = 0.819). Further, analysis of ICD-10 codes demonstrated a clear bias toward utilizing less specified codes. Conclusions: Despite a five-fold increase in available diagnostic codes for spine conditions in ICD-10, in the year after implementation providers continued to select a small proportion of less specific diagnostic codes when treating spine patients.
topic Spine
Clinical coding
International classification of diseases
Codes
ICD
ICD-9-CM
url http://www.sciencedirect.com/science/article/pii/S2666548420300354
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