Evaluation of an Automated Software Method Versus a Delphi Process to Translate Emergency General Surgery ICD...

This study provides an up-to-date diagnosis framework for the study of emergency general surgery (EGS) patients. A final list of International Classification of Diseases, Tenth Revision (ICD-10) codes was the main outcome for the study. Codes were compared with the number codes generated by MapIT alone.

Since transition to ICD-10, a Delphi process to define EGS diagnoses, as originally described for the ICD, Ninth Revision (ICD-9) codeset, has not been performed. Automated mapping software (MapIT) has been utilized, with a few studies verifying the translation.

Using previously defined ICD-9 EGS codes, MapIT was used to identify ICD-10 EGS codes. Review of adjacent codes in a Delphi process resulted in a finalized list of ICD-10 codes. Delphi and MapIT codes were quantified in the Nationwide Inpatient Sample to compare rates to the ICD-9 era.

MapIT identified 935 ICD-10 codes from 485 ICD-9 codes. Manual review identified an additional 1907 adjacent codes. In total, after the modified Delphi process, 1579 (55.6%) of manually and MapIT-identified codes were included in the final codeset. After initial mapping, 880 (55.7%) of the final codes did not automatically map through the software. MapIT codes resulted in a significantly decreased number of patient encounters in the Nationwide Inpatient Sample compared with Delphi codes in the ICD-10 era.

The Delphi-created ICD-10 EGS codeset provides a more robust, accurate translation of the ICD-9 codes than MapIT software. This codeset can be used to inform EGS research to study and improve EGS patients' care.