Concordance between ICD-10-AM clinical coding and SARS-CoV-2 PCR testing for COVID-19 in Australian hospitals

Area of Science:

• Health Informatics
• Epidemiology
• Public Health

Background:

• The World Health Organization introduced ICD-10 codes for COVID-19 to standardize global reporting.
• Accurate coding is crucial for public health efforts, but concordance with laboratory confirmation in Australia was unexamined.

Purpose of the Study:

• To evaluate the accuracy of ICD-10-AM code U07.1 against SARS-CoV-2 PCR results in Australian hospital admissions.
• To improve COVID-19 case identification within electronic medical records.

Main Methods:

• Retrospective analysis of electronic medical records from 13 New South Wales public hospitals.
• Comparison of ICD-10-AM code U07.1 with SARS-CoV-2 PCR test results as the reference standard.
• Calculation of sensitivity, specificity, and predictive values; mixed-effects logistic regression used for concordance analysis.

Main Results:

• Out of 25,724 admissions tested, 39.4% had positive SARS-CoV-2 PCR results.
• ICD-10-AM code U07.1 demonstrated high accuracy: sensitivity of 91.5% for conventional PCR and 94.1% for rapid PCR.
• The coding system showed excellent concordance with laboratory-confirmed COVID-19 cases.

Conclusions:

• ICD-10-AM code U07.1 is a reliable indicator of COVID-19 in Australian hospital data.
• The findings support the use of this code for surveillance and research purposes.
• Continuous improvement in clinical coding practices is essential to minimize misclassification and enhance public health planning.