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US ICD-9/ICD-10 Comparability for Injury

US ICD-9/ICD-10 Comparability for Injury. Margaret Warner, Ph.D. Office of Analysis and Epidemiology ICE on Injury Statistics, Vienna, June 2004. Centers for Disease Control and Prevention National Center for Health Statistics. The U.S. ICD-9/ICD-10 Comparability Study. Purpose

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US ICD-9/ICD-10 Comparability for Injury

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  1. US ICD-9/ICD-10 Comparability for Injury Margaret Warner, Ph.D. Office of Analysis and Epidemiology ICE on Injury Statistics, Vienna, June 2004 Centers for Disease Control and Prevention National Center for Health Statistics

  2. The U.S. ICD-9/ICD-10 Comparability Study • Purpose • To measure the effect of ICD-10 on cause of death trends • To provide a check on the ICD-10 automated coding systems

  3. The U.S. ICD-9/ICD-10 Comparability Study • Preliminary results published in 2001 • National Vital Statistics Reports vol 49 no 2 • based on about 80 percent of 1996 mortality records • Final comparability data include all 1996 multiple cause mortality • ICD-10 information is available for more than 99 percent, some known errors in the data file • File will be available to public

  4. Products from NCHS • Produce a final report on ICD-9/ICD-10 comparability for all deaths (future) • Maintain (in-house) updated version of file with corrections and modifications • For injury: • CR are available for cells and marginals of EC matrix • Comparability for specific nature of injury codes (e.g. TBI)

  5. Development of Comparability EC Matrix • Majority of comparisons on cells and marginals of EC matrix • ICD-10 matrix developed to be consistent with ICD-9 matrix where possible • Some movement of codes based on changes to ICD-10 (e.g. MVTC) and updates (e.g. drowning) • For trends, ICD-9 External cause matrix adjusted to match ICD-10 matrix

  6. Comparability ratios different from 1 expressed as percent 60 50 40 30 Struck by, against Unspecified Suffocation 20 Other specified NEC Natural/Environ Poisoning Other spec Machinery Cut/pierce Drowning 10 MVTC 0 -10 -20

  7. Example: Falls • CR = 1.0015 or .2 % increase • Total ICD-9 = 11,483 • Total ICD-10 = 11,500 • Agreement 10,840 89 % • Outflows (ICD-9 & not ICD-10) 643 5.3% • Inflows (ICD-10 & not ICD-9) 660 5.4%

  8. More injuries in ICD-10 than ICD-9 • All injuries, Comparability Ratio = 1.0159 • 2,391 more deaths with underlying cause of injury in ICD-10 than ICD-9 • In ICD-10, 33% of 2,391 were classified as unintentional suffocations • In ICD-9, 17% of 2,391 were classified as Pneumonia • Change in selection rules for underlying cause

  9. Conclusion • On web in near future-- Death and death rates for ICD-9 comparability modified EC matrix by age and sex • Examples of how to deal with trend data in many publications from NCHS (e.g. Health, US) • Guidelines with examples on how to do analysis available • Lots more work here!!!

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