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Administrative coding methods impact surgical site infection rates.

Mohammed A Alsuhaibani1,2, Mohammed A Alzunitan1,3, Kyle E Jenn1

  • 1University of Iowa Carver College of Medicine, Iowa City, Iowa, United States.

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Surgical site infection (SSI) rates differ based on whether International Classification of Diseases, Tenth Revision procedure codes (ICD-10) or Current Procedural Terminology codes (CPT) are used. This variation can affect how hospitals compare their performance.

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Area of Science:

  • Healthcare Informatics
  • Surgical Quality Measurement
  • Medical Coding Systems

Background:

  • Accurate calculation of surgical site infection (SSI) rates is crucial for monitoring healthcare quality.
  • Standardized coding systems are essential for consistent data collection and analysis in healthcare.

Purpose of the Study:

  • To evaluate the impact of using different procedural coding systems, specifically International Classification of Diseases, Tenth Revision procedure codes (ICD-10) and Current Procedural Terminology (CPT) codes, on the calculation of surgical site infection (SSI) rates.
  • To determine if the choice of coding system influences interhospital comparisons of SSI rates.

Main Methods:

  • A retrospective analysis was conducted.
  • The study compared SSI rates derived using ICD-10 procedure codes versus CPT codes.
  • The impact on denominator calculation and resulting SSI rates was assessed.

Main Results:

  • The study found that denominators used for calculating SSI rates varied significantly depending on the coding system employed (ICD-10 vs. CPT).
  • Consequently, the calculated SSI rates also differed based on the coding method used.
  • These variations suggest that the choice of coding system can impact the observed performance metrics.

Conclusions:

  • The method of procedural coding (ICD-10 vs. CPT) significantly affects surgical site infection (SSI) rate calculations.
  • Variations in SSI rates due to coding methods may lead to inaccurate interhospital performance comparisons.
  • Standardization or clear reporting of the coding methodology is recommended for reliable quality assessment.