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Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction
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Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction

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Validation of international classification of diseases, tenth revision, clinical modification diagnosis codes for

Gaia Pocobelli1, Laura Ichikawa1, Onchee Yu1

  • 1Kaiser Permanente Washington Health Research Institute, Washington, District of Columbia, USA.

Pharmacoepidemiology and Drug Safety
|June 7, 2022
PubMed

Insights

International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes for heart failure (HF) may not be sufficient for identifying reduced ejection fraction HF. However, these codes show adequacy in identifying preserved ejection fraction HF.

Area of Science:

  • Cardiology
  • Health Informatics

Background:

  • Accurate identification of heart failure (HF) subtypes is crucial for effective patient management and research.
  • International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes are widely used for clinical data abstraction, but their accuracy for specific HF phenotypes requires validation.

Purpose of the Study:

  • To evaluate the positive predictive value (PPV) of ICD-10-CM diagnosis codes for identifying different subtypes of heart failure.
  • To determine the adequacy of ICD-10-CM codes for classifying patients with reduced ejection fraction (rEF), mid-range ejection fraction (mEF), and preserved ejection fraction (pEF).

Main Methods:

  • A cohort of Kaiser Permanente Washington enrollees with ICD-10-CM HF diagnosis codes and echocardiogram data between 2017-2018 was analyzed.
  • Left ventricular ejection fraction (LVEF) from medical chart review served as the gold standard for HF subtype classification.
  • A random sample of 1000 patients was selected for detailed medical chart review to ascertain LVEF.

Main Results:

  • The ICD-10-CM code group I50.20-I50.23 (Systolic heart failure) had the highest PPV for rEF (41.4%) and for mEF or rEF (70.2%).
  • The ICD-10-CM code group I50.30-I50.33 (Diastolic heart failure) demonstrated the highest PPV for pEF (92.0%) and for mEF or pEF (97.7%).

Conclusions:

  • ICD-10-CM codes alone may not be sufficiently accurate for identifying patients with reduced ejection fraction heart failure.
  • These codes appear adequate for identifying patients with preserved ejection fraction heart failure.
  • Variations in HF coding practices across different healthcare settings may influence the generalizability of these findings.
Abstract

Keywords:
ICD-10electronic health recordsheart failurepositive predictive valuevalidation

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