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Development and Validation of an Algorithm to Classify as Equivalent the Procedures in ICD-10-PCS That Differ Only by
Richard H Epstein1, Franklin Dexter2, Liam O'Neill3
1From the Department of Anesthesiology, Pain Management and Perioperative Medicine, University of Miami, Miami, Florida.
Anesthesia and Analgesia
|May 17, 2019
Summary
The switch to International Classification of Diseases, Tenth Revision, Procedure Coding System (ICD-10-PCS) increased codes due to laterality. An algorithm found laterality had a small effect on surgical diversity, suggesting combined codes for analysis.
Area of Science:
- Health Informatics
- Medical Coding Systems
- Surgical Procedure Analysis
Background:
- The transition to International Classification of Diseases, Tenth Revision, Procedure Coding System (ICD-10-PCS) significantly expanded the number of procedure codes.
- This expansion was largely driven by the inclusion of laterality (e.g., left vs. right side).
Purpose of the Study:
- To identify and analyze pairs of ICD-10-PCS codes representing mirror-image, surgically equivalent procedures.
- To quantify the impact of laterality on surgical diversity within major therapeutic procedures.
Main Methods:
- Developed a structured query language (SQL) algorithm to detect ICD-10-PCS codes differing solely by laterality.
- Analyzed two quarters of Texas discharge abstracts to assess the effect on surgical diversity.
Main Results:
- In federal fiscal year 2017, 22.3% of ICD-10-PCS codes were pairs differing only by laterality.
- Combining these codes reduced surgical diversity in Texas from 78.2 to 74.1 procedures.
Conclusions:
- An algorithm effectively identifies ICD-10-PCS codes differentiated only by laterality.
- Laterality has a minor influence on overall surgical diversity for major procedures.
- The developed SQL code and lookup table are valuable tools for US inpatient analyses using ICD-10-PCS data.
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