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Diabetes Complications Severity Index (DCSI)-Update and ICD-10 translation
William P Glasheen1, Andrew Renda2, Yanting Dong3
1Humana Inc., Clinical Analytics, 101 S. Fifth Street, 11th Floor, Louisville, KY 40202, USA.
Aims:
The Diabetes Complications Severity Index (DCSI) converts diagnostic codes and laboratory results into a 14-level metric quantifying the long-term effects of diabetes on seven body systems. Adoption of the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) necessitates translation from ICD-9-CM and creates refinement opportunities.
Methods:
ICD-9 codes for secondary and primary diabetes plus all five ICD-10 diabetes categories were incorporated into an updated tool. Additional modifications were made to improve the accuracy of severity assignments.
Subjects:
The tools were tested in a Medicare Advantage population.
Results:
In the type 2 subpopulation, prevalence steadily declined with increasing score according to the updated DCSI tool, whereas the original tool resulted in an aberrant local prevalence peak at DCSI = 2. In the type 1 subpopulation, score prevalence was greater in type 1 versus type 2 subpopulations (3 versus 0) according to both instruments. Both instruments predicted current-year inpatient admissions risk and near-future mortality, using either purely ICD-9 data or a mix of ICD-9 and ICD-10 data.
Discussion:
While the performance of the tool with purely ICD-10 data has yet to be evaluated, this updated tool makes assessment of diabetes patient severity and complications possible in the interim.