Quantifying Plastic and Reconstructive Surgery Engagement in the Evolution of ICD-10 Codes

Area of Science:

• Medical Informatics
• Health Services Research
• Surgical Specialties

Background:

• Accurate diagnostic documentation relies on International Classification of Diseases (ICD)-10 code specificity.
• Limited granularity in plastic surgery coding negatively impacts clinical documentation, education, research, and patient care.
• This study investigates plastic surgery's engagement with ICD-10 code modification over the past decade.

Purpose of the Study:

• To examine the extent of ICD-10 code modification efforts by plastic surgeons and organizations.
• To detail the formal proposal process for ICD-10 code changes.
• To identify potential areas for future coding modifications in plastic surgery.

Main Methods:

• Retrospective review of ICD-10 modification proposals from March 2013 to March 2023.
• Identification and evaluation of plastic surgery-related proposals for implementation success.
• Comparative analysis with other surgical specialties using Fisher exact and 2-tailed t-tests.

Main Results:

• Out of 472 unique proposals, 111 (23.5%) were from surgical specialties, with 41 (36.9%) initiated by surgeons.
• Overall success rate for surgical proposals was 85.6%, with an average implementation time of 24.7 months.
• Only 2 (1.8%) of all surgical proposals were specific to plastic surgery, and both were successfully implemented.

Conclusions:

• Plastic surgeons have minimally utilized the ICD-10 revision process in the last decade.
• The high success rate of surgical proposals suggests the process is feasible for plastic surgery.
• Engaging in the ICD-10 code revision process offers a viable method for plastic surgeons to improve clinical documentation and patient care.