Implementer report: ICD-10 code F44.5 review for functional seizure disorder.
Sana F Ali1,2,3, Yarden Bornovski4, Margaret Gopaul1
1Neurology, Yale School of Medicine, New Haven, Connecticut, USA.
BMJ Health & Care Informatics
|September 20, 2023
Summary
The International Classification of Diseases, 10th Edition (ICD-10) code F44.5 for functional seizure disorder (FSD) has a low 44% positive predictive value in the VA EHR. Improvements in information systems are needed for accurate diagnostic coding.
Area of Science:
- Medical Informatics
- Clinical Informatics
- Health Information Systems
Background:
- The International Classification of Diseases, 10th Edition (ICD-10) introduced code F44.5 to specifically identify functional seizure disorder (FSD).
- Accurate diagnostic coding is crucial for patient care, research, and healthcare system management.
Purpose of the Study:
- To evaluate the validity of the ICD-10 code F44.5 for functional seizure disorder (FSD) within the Veterans Affairs Connecticut Healthcare System electronic health record (VA EHR).
Main Methods:
- Utilized an informatics search tool and a natural language processing algorithm.
- Conducted a comprehensive chart review to validate FSD coding accuracy.
Main Results:
- The positive predictive value (PPV) for ICD-10 code F44.5 was determined to be 44%.
- This indicates a significant discrepancy between coded diagnoses and actual clinical documentation for FSD.
Conclusions:
- The current ICD-10 code F44.5 demonstrates limited validity for FSD, necessitating improvements in diagnostic coding precision.
- Enhancements to the EHR system, including curated ICD-10 term lists and appropriate code classification under neurology and psychiatry, are recommended to improve accuracy.
Keywords:
BMJ Health InformaticsDecision Support Systems, ClinicalElectronic Health RecordsHealth Information SystemsHealthcare Common Procedure Coding SystemMore Related Videos
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