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Validity of using ICD-9-CM codes to identify selected categories of obstetric complications, procedures and

Sarah L Goff1, Penelope S Pekow, Glenn Markenson

  • 1Department of Pediatrics, Center for Quality of Care Research, Baystate Medical Center, Springfield, MA 01199, USA. sarah.goff@bhs.org

Paediatric and Perinatal Epidemiology
|August 14, 2012
PubMed

Insights

Using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes to track obstetric complications is valid for most categories, except for obesity. This method aids in improving obstetric quality of care.

Area of Science:

  • Obstetrics and Gynecology
  • Health Services Research
  • Medical Informatics

Background:

  • Administrative data, including International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes, are increasingly used to monitor obstetric quality of care.
  • The validity of using these codes to identify obstetric complications and associated risk factors requires thorough evaluation.

Purpose of the Study:

  • To assess the validity of using composite sets of ICD-9-CM codes to identify specific obstetric complications.
  • To evaluate the accuracy of administrative data in capturing obstetric trauma, infection, hemorrhage, episiotomy, and obesity.

Main Methods:

  • Retrospective review of administrative data from January 2009 to March 2010.
  • Random selection of 100 medical records for five complication categories (trauma, infection, hemorrhage, episiotomy, obesity) and 60 control records per category.
  • Estimation of sensitivity and specificity using inverse proportional weighting.

Main Results:

  • High specificity was observed for most categories (episiotomy: 0.999, infection: 0.998, hemorrhage: 0.997, trauma: 0.995).
  • Sensitivity varied significantly, with infection (1.00) and episiotomy (0.83) showing high values, while trauma (0.50) and hemorrhage (0.42) were lower.
  • Obesity identification was unreliable (sensitivity: 0.15, specificity: 0.994), with challenges in determining if diagnoses were present on admission.

Conclusions:

  • Composite sets of ICD-9-CM codes demonstrate validity for identifying patients within several obstetric complication categories.
  • The reliability of using ICD-9-CM codes for identifying obesity-related complications needs further investigation.
  • This approach can support efforts to improve obstetric quality of care through better data analysis.
Abstract

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