Coding reliability and agreement of international classification of disease, 10th revision (ICD-10) codes in emergency department data

Introduction: Administrative health data from the emergency department (ED) play important roles in understanding health needs of the public and reasons for health care resource use. International Classification of Disease (ICD) diagnostic codes have been widely used for code reasons of clinica...

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Main Authors: Mingkai Peng, Cathy Eastwood, Alicia Boxill, Rachel Joy Jolley, Laura Rutherford, Karen Carlson, Stafford Dean, Hude Quan
Format: Article
Language:English
Published: Swansea University 2018-07-01
Series:International Journal of Population Data Science
Subjects:
Online Access:https://ijpds.org/article/view/445
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spelling doaj-f44962ce2e68426a94803d6d3550dab42020-11-24T21:49:05ZengSwansea UniversityInternational Journal of Population Data Science2399-49082018-07-013110.23889/ijpds.v3i1.445445Coding reliability and agreement of international classification of disease, 10th revision (ICD-10) codes in emergency department dataMingkai Peng0Cathy Eastwood1Alicia Boxill2Rachel Joy Jolley3Laura Rutherford4Karen Carlson5Stafford Dean6Hude Quan7University of CalgaryUniversity of CalgaryUniversity of CalgaryUniversity of CalgaryAlberta Health ServicesAlberta Health ServicesAlberta Health ServicesUniversity of Calgary Introduction: Administrative health data from the emergency department (ED) play important roles in understanding health needs of the public and reasons for health care resource use. International Classification of Disease (ICD) diagnostic codes have been widely used for code reasons of clinical encounters for administrative purposes in EDs. Objective: The purpose of the study is to examine the coding agreement and reliability of ICD diagnosis codes in ED through auditing the routinely collected data. Methods: We randomly sampled 1 percent of records (n=1636) between October and December from 11 emergency departments in Alberta, Canada. Auditors were employed to review the same chart and independently assign main diagnosis codes. We assessed coding agreement and reliability through comparison of codes assigned by auditors and hospital coders using the proportion of agreement and Cohen’s kappa. Error analysis was conducted to review diagnosis codes with disagreement and categorized them into six groups. Results: Overall, the agreement was 86.5% and 82.2% at 3 and 4 digits levels respectively, and reliability was 0.86 and 0.82 respectively. Variation of agreement and reliability were identified across different emergency departments. The major two categories of coding discrepancy were the use of different codes for the same condition (23.6%) and the use of codes at different levels of specificity (20.9%). Conclusions: Diagnosis codes in emergency department show high agreement and reliability. More strict coding guidelines regarding the use of unspecified codes are needed to enhance coding consistency. https://ijpds.org/article/view/445coding agreement and reliability, ICD-10 codes, Emergency department
collection DOAJ
language English
format Article
sources DOAJ
author Mingkai Peng
Cathy Eastwood
Alicia Boxill
Rachel Joy Jolley
Laura Rutherford
Karen Carlson
Stafford Dean
Hude Quan
spellingShingle Mingkai Peng
Cathy Eastwood
Alicia Boxill
Rachel Joy Jolley
Laura Rutherford
Karen Carlson
Stafford Dean
Hude Quan
Coding reliability and agreement of international classification of disease, 10th revision (ICD-10) codes in emergency department data
International Journal of Population Data Science
coding agreement and reliability, ICD-10 codes, Emergency department
author_facet Mingkai Peng
Cathy Eastwood
Alicia Boxill
Rachel Joy Jolley
Laura Rutherford
Karen Carlson
Stafford Dean
Hude Quan
author_sort Mingkai Peng
title Coding reliability and agreement of international classification of disease, 10th revision (ICD-10) codes in emergency department data
title_short Coding reliability and agreement of international classification of disease, 10th revision (ICD-10) codes in emergency department data
title_full Coding reliability and agreement of international classification of disease, 10th revision (ICD-10) codes in emergency department data
title_fullStr Coding reliability and agreement of international classification of disease, 10th revision (ICD-10) codes in emergency department data
title_full_unstemmed Coding reliability and agreement of international classification of disease, 10th revision (ICD-10) codes in emergency department data
title_sort coding reliability and agreement of international classification of disease, 10th revision (icd-10) codes in emergency department data
publisher Swansea University
series International Journal of Population Data Science
issn 2399-4908
publishDate 2018-07-01
description Introduction: Administrative health data from the emergency department (ED) play important roles in understanding health needs of the public and reasons for health care resource use. International Classification of Disease (ICD) diagnostic codes have been widely used for code reasons of clinical encounters for administrative purposes in EDs. Objective: The purpose of the study is to examine the coding agreement and reliability of ICD diagnosis codes in ED through auditing the routinely collected data. Methods: We randomly sampled 1 percent of records (n=1636) between October and December from 11 emergency departments in Alberta, Canada. Auditors were employed to review the same chart and independently assign main diagnosis codes. We assessed coding agreement and reliability through comparison of codes assigned by auditors and hospital coders using the proportion of agreement and Cohen’s kappa. Error analysis was conducted to review diagnosis codes with disagreement and categorized them into six groups. Results: Overall, the agreement was 86.5% and 82.2% at 3 and 4 digits levels respectively, and reliability was 0.86 and 0.82 respectively. Variation of agreement and reliability were identified across different emergency departments. The major two categories of coding discrepancy were the use of different codes for the same condition (23.6%) and the use of codes at different levels of specificity (20.9%). Conclusions: Diagnosis codes in emergency department show high agreement and reliability. More strict coding guidelines regarding the use of unspecified codes are needed to enhance coding consistency.
topic coding agreement and reliability, ICD-10 codes, Emergency department
url https://ijpds.org/article/view/445
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