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.
Objective:
The study aimed to measure the validity of International Classification of Diseases, 10th Edition (ICD-10) code F44.5 for functional seizure disorder (FSD) in the Veterans Affairs Connecticut Healthcare System electronic health record (VA EHR).
Methods:
The study used an informatics search tool, a natural language processing algorithm and a chart review to validate FSD coding.
Results:
The positive predictive value (PPV) for code F44.5 was calculated to be 44%.
Discussion:
ICD-10 introduced a specific code for FSD to improve coding validity. However, results revealed a meager (44%) PPV for code F44.5. Evaluation of the low diagnostic precision of FSD identified inconsistencies in the ICD-10 and VA EHR systems.
Conclusion:
Information system improvements may increase the precision of diagnostic coding by clinicians. Specifically, the EHR problem list should include commonly used diagnostic codes and an appropriately curated ICD-10 term list for 'seizure disorder,' and a single ICD code for FSD should be classified under neurology and psychiatry.
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