Translating coding lists in administrative claims-based research for cardiovascular procedures.

Area of Science:

• Healthcare Informatics
• Medical Coding Systems
• Vascular Surgery Research

Background:

• Administrative claims require validated algorithms to infer clinical events.
• The United States transitioned from International Classification of Diseases Ninth Revision (ICD-9) to ICD-10 in October 2015.
• Deriving new ICD-10 codes from existing ICD-9 codes is crucial for continuity in healthcare research.

Purpose of the Study:

• To describe a method for deriving new ICD-10 codes for vascular procedure outcomes from validated ICD-9 codes.
• To adapt existing validated ICD-9 coding lists for use with the ICD-10 system.
• To ensure the clinical relevance and accuracy of ICD-10 codes for research.

Main Methods:

• Began with validated ICD-9 coding lists for specific vascular procedures.
• Utilized general equivalence mapping tools to translate ICD-9 codes to ICD-10.
• Conducted manual review by multiple authors to ensure clinical relevance and remove duplicates.

Main Results:

• A total of 475 ICD-9 codes translated to 46,630 ICD-10 codes, a 98-fold increase.
• Manual review identified 77% of mapped ICD-10 codes as duplicated or not clinically relevant.
• The final reviewed list contained 4,736 ICD-10 codes, a 49-fold increase from the ICD-9 list.

Conclusions:

• ICD-10 significantly expanded the code set for vascular procedure outcomes.
• Over 75% of codes derived via general equivalence mapping lacked clinical relevance or were duplicates.
• Manual review by clinicians is imperative for accurate ICD-10 code selection in research.