Defining radical cystectomy using the ICD-10 procedure coding system.

Area of Science:

• Urology
• Health Informatics
• Medical Coding

Background:

• The International Classification of Diseases-10-Procedure Coding System (ICD-10-PCS) presents challenges for identifying specific procedures like radical cystectomy (RC) in administrative datasets.
• Existing coding systems lack a standardized definition for RC, complicating data analysis and research.

Purpose of the Study:

• To develop and internally validate a precise list of ICD-10-PCS codes for identifying radical cystectomy (RC).
• To improve the accuracy of identifying RC procedures within large administrative healthcare databases.

Main Methods:

• Radical cystectomies (RCs) from 2019-2020 were identified from prospectively maintained registries.
• Candidate ICD-10-PCS codes were compiled and iteratively refined by comparing billing data against registry cases.
• The developed code list was validated using separate training and validation cohorts.

Main Results:

• The validated list accurately identified 99% of radical cystectomies (RCs) for bladder cancer in the training cohort and 97% in the validation cohort.
• The coding strategy demonstrated high fidelity, with minimal misidentification of benign or non-urologic cancer cases.

Conclusions:

• The developed list of ICD-10-PCS codes offers a reliable method for researchers to identify radical cystectomy (RC) in administrative datasets.
• This validated coding approach can enhance the accuracy and scope of research utilizing electronic health records and billing information.