Related Experiment Video
Updated: Oct 16, 2025
09:01
Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach
Published on: January 24, 2018
12.0K
ICD-10 codes do not accurately reflect ankle fracture injury patterns
Ryan A Seltzer1, Noelle L Van Rysselberghe2, Andrew T Fithian2
1Stanford University School of Medicine, 291 Campus Drive, Stanford, CA 94305-5101, United States of America.
Injury
|October 16, 2021
Summary
ICD-10 coding for ankle fractures shows significant inaccuracies, with electronic medical record codes differing from surgeon assignments in over 60% of cases. This highlights the need for improved coding practices in healthcare data research.
Area of Science:
- Orthopedic Surgery
- Medical Informatics
- Health Services Research
Background:
- Accurate coding of injuries is crucial for clinical research and healthcare management.
- International Classification of Disease Version 10 (ICD-10) codes are widely used for injury surveillance and billing.
- Ankle fractures represent a common and complex group of injuries requiring precise classification.
Purpose of the Study:
- To evaluate the accuracy of ICD-10 coding for ankle fracture injury patterns.
- To compare electronic medical record (EMR) assigned ICD-10 codes with surgeon-verified codes.
Main Methods:
- A retrospective cohort study included 97 adult patients with ankle or distal tibia fractures.
- Injury radiographs were reviewed by three authors to determine the correct ICD-10 code.
- Agreement between EMR and surgeon codes was assessed using kappa statistics, percent agreement, sensitivity, specificity, and positive predictive value (PPV).
Main Results:
- A significant discordance (60.8%) was found between EMR and surgeon-assigned ICD-10 codes.
- Overall agreement was fair (kappa = 0.26).
- Codes for lateral malleolus fractures had the highest PPV (0.91), while "other fractures" had very low PPVs (0.05 and 0.0). Generalized "other fracture" codes were overused in EMRs (45% vs 6%).
Conclusions:
- Substantial discordance exists between EMR and surgeon-assigned ICD-10 codes for ankle fractures.
- Research relying on ICD-10 codes for ankle fractures should be interpreted cautiously.
- Healthcare institutions should prioritize improving the accuracy of ICD-10 coding for ankle injuries.
Related Concept Videos
01:27Fractures: Bone Repair
4.0K
Treatment for a fracture is based on the type of break, the bone affected, and the patient's age.
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the...
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the...
4.0K
01:10Ankle Joint
2.1K
The ankle is formed by the talocrural joint (crural = leg). It consists of the articulations between the talus bone of the foot and the distal ends of the tibia and fibula of the leg. The superior aspect of the talus bone is square-shaped and has three areas of articulation. The top of the talus articulates with the inferior tibia. This is the portion of the ankle joint that carries the body weight between the leg and foot. The sides of the talus are firmly held in position by the articulations...
2.1K