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Related Experiment Videos

The challenge of mapping between two medical coding systems.

Barbara E Wojcik1, Catherine R Stein, Raymond B Devore

  • 1Center for Army Medical Department Strategic Studies, U.S. Army Medical Department Center and School, Fort Sam Houston, TX 78234-5047, USA.

Military Medicine
|December 13, 2006
PubMed
Summary

Reliable conversion between patient conditions (PCs) and International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes is moderately supported. This suggests PCs need modification for verifiable data linkage.

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Area of Science:

  • Medical informatics
  • Health services research
  • Military medicine

Background:

  • Patient conditions (PCs) are used by the U.S. military to estimate medical resources for combat operations.
  • Current PCs are based on expert opinion and lack direct ties to medical data or standard coding systems.
  • Existing mechanisms do not link current or historical medical data to PCs.

Purpose of the Study:

  • To assess the feasibility of reliably converting patient condition codes to ICD-9-CM diagnosis codes.
  • To determine if a verifiable link can be established between military-specific patient conditions and standard medical classifications.

Main Methods:

  • Three professional coders assigned all applicable ICD-9-CM diagnosis codes to each PC code.
  • Inter-rater reliability was evaluated using Cohen's K statistic and percent agreement.

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  • Developed methods to calculate kappa statistics for multiple category selections.

    • Main Results:

    • Moderate support was found for the reliable conversion between PCs and ICD-9-CM diagnoses.
    • The average kappa statistic indicated moderate agreement (mean kappa = 0.61).

    Conclusions:

    • The current patient condition system requires modification to enable verification with real-world medical data.
    • Establishing a data-verifiable system for PCs is crucial for accurate medical resource estimation.