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Related Experiment Videos

Coding algorithms for defining comorbidities in ICD-9-CM and ICD-10 administrative data.

Hude Quan1, Vijaya Sundararajan, Patricia Halfon

  • 1Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada. hquan@ucalgary.ca

Medical Care
|October 15, 2005
PubMed
Summary

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New International Statistical Classification of Disease and Related Health Problems, 10th Revision (ICD-10) coding algorithms for Charlson and Elixhauser comorbidities show similar prevalence estimates and improved mortality prediction compared to existing methods.

Area of Science:

  • Health Informatics
  • Medical Coding Systems
  • Administrative Data Analysis

Background:

  • Implementing the International Statistical Classification of Disease and Related Health Problems, 10th Revision (ICD-10) presents challenges for administrative data utilization.
  • Existing algorithms for defining comorbidities (Charlson and Elixhauser) were developed using the ICD-9-CM system.

Purpose of the Study:

  • To develop and assess the performance of ICD-10 coding algorithms for defining Charlson and Elixhauser comorbidities in administrative data.
  • To compare the accuracy of new ICD-10 algorithms against existing ICD-9-CM algorithms for comorbidity prevalence and mortality prediction.

Main Methods:

  • Developed ICD-10 algorithms by translating ICD-9-CM codes and physician assessment of ICD-10 code validity.
  • Created enhanced ICD-9-CM algorithms concurrently.

Related Experiment Videos

  • Assessed comorbidity frequencies and in-hospital mortality prediction using Canadian administrative hospital discharge data (ICD-9-CM and ICD-10).

    • Main Results:

    • New ICD-10 and enhanced ICD-9-CM algorithms yielded similar comorbidity prevalence estimates compared to original algorithms.
    • The new ICD-10 and enhanced ICD-9-CM algorithms demonstrated equal or superior performance in predicting in-hospital mortality.
    • C-statistics for mortality prediction ranged from 0.842 to 0.878, with ICD-10 and enhanced ICD-9-CM algorithms generally achieving higher values.

    Conclusions:

    • Newly developed ICD-10 and ICD-9-CM comorbidity coding algorithms provide comparable comorbidity prevalence estimates.
    • These advanced algorithms may offer superior performance over existing ICD-9-CM algorithms for administrative data analysis.