[Validation of the ICD-11 beta draft in hand surgery]

Area of Science:

• Hand Surgery
• Medical Coding Systems
• Orthopedics

Background:

• Hand surgery involves treating complex injuries and diseases, posing coding challenges with the ICD-10-GM.
• Accurate coding is crucial for reliable patient case documentation and analysis.
• The International Classification of Diseases, 11th Revision (ICD-11) aims to improve coding specificity.

Purpose of the Study:

• To evaluate the representation and coding accuracy of hand injuries and diseases within the ICD-11 beta draft.
• To identify challenges and gather suggestions for improving ICD-11 coding in hand surgery.

Main Methods:

• A case-oriented validation study involving 23 hand surgeons from nine institutions.
• Coding of 315 real-life case scenarios (210 short statements, 105 comprehensive descriptions) using the ICD-11 beta draft.
• Telephone interviews were conducted to gather qualitative feedback on the coding experience.

Main Results:

• Substantial agreement (Krippendorff's alpha = 0.67) was observed between coding physicians for both scenario types.
• Coding difficulties were reported in approximately one-third of scenarios (27% of short statements, 35% of comprehensive descriptions).
• Specific coding problems and suggestions for improvement were documented through interviews and verified by a working group.

Conclusions:

• The ICD-11 beta draft demonstrates satisfactory inter-rater reliability for hand surgery coding.
• The study's findings led to important adaptations in the ICD-11 for hand surgery.
• ICD-11 is expected to enable more unambiguous and specific coding of hand injuries and diseases, particularly multiple injuries.