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Related Concept Videos

Appendicitis-II: Diagnostic Studies and Management01:29

Appendicitis-II: Diagnostic Studies and Management

145
Diagnosing and managing appendicitis requires a structured and comprehensive approach that spans from initial assessment to postoperative care. Here is an overview of the process:
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
145

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Updated: Sep 11, 2025

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A Pervasive Problem: Surgical Wound Class Miscoding in Pediatric Laparoscopic Appendectomy.

John M Woodward1, Michael LaRock2, Krystle Bittner3

  • 1University at Buffalo Department of Surgery, Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY 14215, USA; University at Buffalo Division of Pediatric Surgery, Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY 14215, USA.

Journal of Pediatric Surgery
|August 15, 2025
PubMed
Summary
This summary is machine-generated.

Surgical wound classification (SWC) miscoding is common in pediatric appendectomies, affecting over 20% of cases. This rate doubles to 50% for perforated appendicitis, impacting data accuracy.

Keywords:
EducationLaparoscopic appendectomyMiscodingNSQIP pediatricPredictive modelingSurgical wound classification (SWC)

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Area of Science:

  • Pediatric Surgery
  • Surgical Quality Improvement
  • Health Informatics

Background:

  • Surgical wound classification (SWC) is crucial for predicting surgical site infections (SSIs), patient outcomes, and hospital quality assessment.
  • Accurate SWC is essential for reliable risk adjustment and research in surgical quality.

Purpose of the Study:

  • To determine the prevalence of SWC miscoding in pediatric laparoscopic appendectomies using a national database.
  • To identify miscoding rates in both non-perforated and perforated acute appendicitis cases.

Main Methods:

  • Analysis of data from the NSQIP-P registry (2017-2021) for pediatric laparoscopic appendectomies (CPT: 44970).
  • Evaluation of SWC based on ICD-10 codes for acute appendicitis (K35-K37).
  • Comparison of coded SWC (1-4) against expected classifications for non-perforated (SWC 3) and perforated (SWC 4) appendicitis.

Main Results:

  • A total of 71,374 procedures were analyzed.
  • An overall SWC miscoding rate of at least 22.5% was identified.
  • The miscoding rate was 28.1% for non-perforated and 49.9% for perforated appendicitis.

Conclusions:

  • Pediatric laparoscopic appendectomies exhibit a significant rate of SWC miscoding, exceeding 20% overall.
  • The miscoding rate approaches 50% for perforated appendicitis, highlighting a critical data quality issue.
  • Improved accuracy in SWC coding is necessary for reliable hospital metrics, risk calculators, and SSI research.