Validation of an International Classification of Disease, Ninth Revision coding algorithm to identify decompressive craniectomy for stroke.

Background: Although International Classification of Disease, Ninth Revision, Clinical Modification (ICD9-CM) coding is the basis of administrative claims data, no study has validated an ICD9-CM algorithm to identify patients undergoing decompressive craniectomy for space-occupying supratentorial in...

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Publicado en:BMC Neurology Vol. 17; pp. 1 - 7
Autores principales: Dasenbrock, Hormuzdiyar H., Cote, David J., Pompeu, Yuri, Vasudeva, Viren S., Smith, Timothy R., Gormley, William B.
Formato: research Journal Article
Publicado: BioMed Central 06/26/2017
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 06/26/2017
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      pub: BioMed Central
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        atl: Validation of an International Classification of Disease, Ninth Revision coding algorithm to identify decompressive craniectomy for stroke.
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          Dasenbrock, Hormuzdiyar H.
          Cote, David J.
          Pompeu, Yuri
          Vasudeva, Viren S.
          Smith, Timothy R.
          Gormley, William B.
        affil: Cushing Neurological Outcomes Center, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA
      sug:
        subj:
          Stroke Surgery
          Decompressive Craniectomy Methods
          International Classification of Diseases
          Infarction Diagnosis
          Young Adult
          Hematoma Surgery
          Sensitivity and Specificity
          Algorithms
          Middle Age
          Stroke Diagnosis
          Retrospective Design
          Female
          Aged
          Male
          Human
          Adult
          Validation Studies
          Comparative Studies
          Evaluation Research
          Multicenter Studies
          Middle Aged: 45-64 years
          Aged: 65+ years
          Adult: 19-44 years
          Female
          Male
      ab: Background: Although International Classification of Disease, Ninth Revision, Clinical Modification (ICD9-CM) coding is the basis of administrative claims data, no study has validated an ICD9-CM algorithm to identify patients undergoing decompressive craniectomy for space-occupying supratentorial infarction.Methods: Patients who underwent decompressive craniectomy for stroke at our institution were retrospectively identified and their associated ICD9-CM codes were extracted from billing data. An ICD9-CM algorithm was generated and its accuracy compared against physician review.Results: A total of 10,925 neurosurgical operations were performed from December 2008 to March 2015, of which 46 (0.4%) were decompressive craniectomy for space-occupying stroke. The ICD9-CM procedure code for craniectomy (01.25) was only encoded in 67.4% of patients, while craniotomy (01.24) was used in 19.6% and lobectomy (01.39, 01.53, 01.59) in 13.1%. The ICD-9-CM algorithm included patients with a diagnosis codes for cerebral infarction (433.11, 434.01, 434.11, and 434.91) and a procedure code for craniotomy, craniectomy, or lobectomy. Patients were excluded with an ICD9-CM diagnosis code for brain tumor, intracranial abscess, subarachnoid hemorrhage, vertebrobasilar infarction, intracranial aneurysm, Moyamoya disease, intracranial venous sinus thrombosis, vertebral artery dissection, congenital cerebrovascular anomaly, head trauma or an ICD9-CM procedure code for laminectomy. This algorithm had a sensitivity of 97.8%, specificity of 99.9%, positive predictive value of 88.2%, and negative predictive value of 99.9%. The majority of false-positive results were patients who underwent evacuation of a primary intracerebral hematoma.Conclusion: An ICD-9-CM algorithm based on diagnosis and procedure codes can effectively identify patients undergoing decompressive craniectomy for supratentorial stroke.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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