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Which ICD-9-CM codes should be used for bronchiolitis research?

Paul Walsh1, Stephen J Rothenberg2

  • 1Pediatric Emergency Medicine, Sutter Medical Center Sacramento, Sacramento, CA, USA. yousentwhohome@gmail.com.

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|November 24, 2018
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Researchers should use broad definitions for bronchiolitis coding in children. Relying on specific diagnosis codes can lead to misclassification, impacting studies using administrative data.

Keywords:
AsthmaBronchiolitisInternational classification of diseasesMisclassificationWheezing

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Area of Science:

  • Pediatrics
  • Health Informatics
  • Epidemiology

Background:

  • Bronchiolitis is a common childhood respiratory illness.
  • Specific ICD-9-CM codes exist, but broader codes are frequently used.
  • This practice risks misclassification in research cohorts.

Purpose of the Study:

  • To examine diagnosis code usage for pediatric wheezing illnesses.
  • To compare narrow vs. broad diagnostic codes in California Medicaid data.
  • To assess patient, geographic, and temporal characteristics of different codes.

Main Methods:

  • Analyzed California Medicaid data for children under 24 months.
  • Categorized diagnosis codes as narrow (bronchiolitis) or broad (bronchitis, asthma, etc.).
  • Compared characteristics across different diagnosis code groups.

Main Results:

  • Acute asthma codes were common, even in infants.
  • Temporal patterns were similar across diagnoses.
  • Geographic variability in code selection was significant.

Conclusions:

  • Broad definitions of bronchiolitis are recommended for administrative data analysis.
  • Researchers should conduct sensitivity analyses comparing broad and narrow definitions.