当代行政代码,以识别肺静脉隔离程序为心房动
Enrico G Ferro1,2, Matthew R Reynolds3, Jiaman Xu1
1Richard A. and Susan F. Smith Center for Outcomes Research Beth Israel Deaconess Medical Center and Harvard Medical School Boston MA USA.
Journal of the American Heart Association
|January 10, 2025
概括
肺静脉隔离 (PVI) 的行政代码对研究来说不可靠. 国际疾病分类,第十修订,程序编码系统 (ICD-10-PCS) 代码不够具体,无法准确识别PVI程序.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 心脏电生理学 心脏电生理学
- 医疗编码系统 医学编码系统
背景情况:
- 肺静脉隔离 (PVI) 越来越多地用于治疗心房动.
- 行政数据对于现实世界的分析是有价值的,但PVI程序代码需要验证.
研究的目的:
- 评估当前程序术语 (CPT) 代码93656和国际疾病分类第十次修订程序编码系统 (ICD-10-PCS) 代码02583ZZ的准确性,用于识别行政索赔数据中的PVI.
主要方法:
- 美国医疗保险服务费受益人的回顾性队列研究 (2017年1月至2021年12月).
- 使用CPT代码93656确定住院PVI并与ICD-10-PCS索赔进行比较.
- 对ICD-10-PCS代码02583ZZ进行了反向匹配,并审查了机构案件的准确性.
主要成果:
- 确定了25617名住院患者的PVI;92%的人使用ICD-10-PCS 02583ZZ收费.
- 根据ICD-10-PCS 02583ZZ计费的程序中,只有21%的程序与CPT 93656 (PVI) 相匹配,表明特异性较低.
- 机构审查确认的CPT代码为PVI识别提供了更大的特异性.
结论:
- ICD-10-PCS代码02583ZZ不是PVI的特异性,并且与其他程序相关,包括心室关节切除.
- 仅仅ICD-10-PCS代码不足以在卫生服务研究中可靠地识别PVI.
- 与行政索赔中的ICD-10-PCS代码相比,CPT代码在识别PVI方面更为具体.
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