Validation of an International Classification of Disease, Ninth Revision coding algorithm to identify decompressive craniectomy for stroke
Abstract 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 supratent...
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| Format: | Article |
| Language: | English |
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BMC
2017-06-01
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| Series: | BMC Neurology |
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| Online Access: | http://link.springer.com/article/10.1186/s12883-017-0864-8 |
| _version_ | 1819155516472950784 |
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| author | Hormuzdiyar H. Dasenbrock David J. Cote Yuri Pompeu Viren S. Vasudeva Timothy R. Smith William B. Gormley |
| author_facet | Hormuzdiyar H. Dasenbrock David J. Cote Yuri Pompeu Viren S. Vasudeva Timothy R. Smith William B. Gormley |
| author_sort | Hormuzdiyar H. Dasenbrock |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-12-22T15:38:13Z |
| format | Article |
| id | doaj.art-e9c2fbfce19d4193b9084181831e930a |
| institution | Directory Open Access Journal |
| issn | 1471-2377 |
| language | English |
| last_indexed | 2024-12-22T15:38:13Z |
| publishDate | 2017-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Neurology |
| spelling | doaj.art-e9c2fbfce19d4193b9084181831e930a2022-12-21T18:21:11ZengBMCBMC Neurology1471-23772017-06-011711610.1186/s12883-017-0864-8Validation of an International Classification of Disease, Ninth Revision coding algorithm to identify decompressive craniectomy for strokeHormuzdiyar H. Dasenbrock0David J. Cote1Yuri Pompeu2Viren S. Vasudeva3Timothy R. Smith4William B. Gormley5Cushing Neurological Outcomes Center, Brigham and Women’s Hospital, Harvard Medical SchoolCushing Neurological Outcomes Center, Brigham and Women’s Hospital, Harvard Medical SchoolCushing Neurological Outcomes Center, Brigham and Women’s Hospital, Harvard Medical SchoolCushing Neurological Outcomes Center, Brigham and Women’s Hospital, Harvard Medical SchoolCushing Neurological Outcomes Center, Brigham and Women’s Hospital, Harvard Medical SchoolCushing Neurological Outcomes Center, Brigham and Women’s Hospital, Harvard Medical SchoolAbstract 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.http://link.springer.com/article/10.1186/s12883-017-0864-8Decompressive craniectomyInternational classification of diseaseIschemic strokeValidation |
| spellingShingle | Hormuzdiyar H. Dasenbrock David J. Cote Yuri Pompeu Viren S. Vasudeva Timothy R. Smith William B. Gormley Validation of an International Classification of Disease, Ninth Revision coding algorithm to identify decompressive craniectomy for stroke BMC Neurology Decompressive craniectomy International classification of disease Ischemic stroke Validation |
| title | Validation of an International Classification of Disease, Ninth Revision coding algorithm to identify decompressive craniectomy for stroke |
| title_full | Validation of an International Classification of Disease, Ninth Revision coding algorithm to identify decompressive craniectomy for stroke |
| title_fullStr | Validation of an International Classification of Disease, Ninth Revision coding algorithm to identify decompressive craniectomy for stroke |
| title_full_unstemmed | Validation of an International Classification of Disease, Ninth Revision coding algorithm to identify decompressive craniectomy for stroke |
| title_short | Validation of an International Classification of Disease, Ninth Revision coding algorithm to identify decompressive craniectomy for stroke |
| title_sort | validation of an international classification of disease ninth revision coding algorithm to identify decompressive craniectomy for stroke |
| topic | Decompressive craniectomy International classification of disease Ischemic stroke Validation |
| url | http://link.springer.com/article/10.1186/s12883-017-0864-8 |
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