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doi: 10.1097/MLR.0b013e318287d59e
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Improved Coding of Postoperative Deep Vein Thrombosis and Pulmonary Embolism in Administrative Data (AHRQ Patient Safety Indicator 12) After Introduction of New ICD-9-CM Diagnosis Codes.

Sadeghi, Banafsheh MD, PhD; White, Richard H. MD, FACP; Maynard, Gregory MD, MSc, SFHM; Zrelak, Patricia PhD, RN, CNRN, NEA-BC; Strater, Amy MPH, MBA; Hensley, Laurie MHA; Cerese, Julie RN, MSN; Romano, Patrick MD, MPH

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Abstract

Background: Symptomatic venous thromboembolism is a common postoperative complication. The Agency for Healthcare Research and Quality (AHRQ) has developed a Patient Safety Indicator 12 to assist hospitals, payers, and other stakeholders to identify patients who experienced this complication.

Objectives: To determine whether newly created and recently redefined ICD-9-CM codes improved the criterion validity of Patient Safety Indicator 12, based on new samples of records dated after October 2009.

Research Design, Subjects, Measures: Two sources of data were used: (1) UHC retrospective case-control study of risk factors for acute symptomatic venous thromboembolism occurring within 90 days after total knee arthroplasty in teaching hospitals; (2) chart abstraction data by volunteer hospitals participating in the Validation Pilot Project of the AHRQ.

Results: In the UHC sample, the positive predictive value (PPV) was 99% (125/126) and the negative predictive value was 99.4% (460/463). In the AHRQ sample, the overall PPV was 81% (126/156).

Conclusions: The PPV based on both samples shows substantial improvement compared with the previously reported PPVs of 43%-48%, suggesting that changes in ICD-9-CM code architecture and better coding guidance can improve the usefulness of coded data.

(C) 2014 by Lippincott Williams & Wilkins.

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