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Updated: Aug 7, 2026
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
International classification of diseases and current procedural terminology codes underestimated thrombolytic use for
Adnan I Qureshi1, Pansy Harris-Lane, Faisal Siddiqi
1Zeenat Qureshi Stroke Research Center, Department of Neurology and Neurosciences, University of Medicine and Dentistry of New Jersey, 90 Bergen Streeet, DOC-8100, Newark, NJ 07103, USA. aiqureshi@hotmail.com
Insights
Accurate identification of thrombolytic use in ischemic stroke requires combining International Classification of Diseases Ninth Revision (ICD-9) and Current Procedural Terminology (CPT) codes. Using either code set alone may underestimate thrombolytic administration.
Area of Science:
- Medical Informatics
- Health Services Research
- Cardiovascular Medicine
Background:
- Accurate coding is essential for health services research and quality assessment.
- New International Classification of Diseases Ninth Revision (ICD-9) procedure and Current Procedural Terminology (CPT) codes exist for thrombolytic therapy.
- The accuracy of these codes for identifying thrombolytic use in ischemic stroke requires evaluation.
Purpose of the Study:
- To assess the accuracy of ICD-9 procedure code 99.10 and CPT codes 37201, 37202 for identifying thrombolytic agent administration in ischemic stroke patients.
- To compare the performance of individual code sets versus a combined approach.
Main Methods:
- Retrospective analysis of University Hospital discharge data.
- Comparison of ICD-9 and CPT codes against a concurrent prospective registry of thrombolysis use.
- Calculation of sensitivity and specificity for code accuracy.
Main Results:
- Of 369 ischemic stroke patients, 49 (13.3%) received thrombolysis.
- ICD-9 code 99.10 demonstrated 55% sensitivity and 98% specificity.
- CPT codes 37201 and 37202 showed 49% sensitivity and 99% specificity.
- Combined ICD-9 and CPT code identification yielded 82% sensitivity and 98% specificity.
Conclusions:
- Individual ICD-9 or CPT codes may underestimate thrombolytic use in national and regional databases.
- A combined approach using both ICD-9 and CPT codes provides more accurate identification of thrombolytic administration.
- Improved coding accuracy is crucial for reliable data in health research and quality improvement initiatives.
Background And Objective:
To determine the accuracy of recently introduced International Classification of Diseases Ninth Revision (ICD-9) procedure and Current Procedural Terminology (CPT) codes designed for injection or infusion of thrombolytic agents.
Materials And Methods:
We determined the accuracy of ICD-9 procedure code 99.10 and CPT codes 37201, 37202 for use of thrombolysis in ischemic stroke by comparing procedure codes of University Hospital discharge data with a concurrent prospective registry.
Results:
Of the 369 ischemic stroke patients, 49 (13.3%) received either intravenous and/or intraarterial thrombolysis. The sensitivity and specificity for ICD-9 procedure code 99.10 was 55% and 98% and CPT procedure code 37201 and 37202 was 49% and 99%. Identification by either ICD-9 codes or CPT codes yielded a high sensitivity and specificity of 82% and 98%.
Conclusions:
The use of ICD-9 and CPT codes alone may underestimate the use of thrombolytics using national and regional database. Best results are achieved when a combination of ICD-9 and CPT codes are used to identify the use of thrombolytics.
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