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Barell Matrix— moving to ICD-10

Barell Matrix— moving to ICD-10. Lois A. Fingerhut May 2004. Barell Matrix . Conceived for injury morbidity Codes based on ICD-9 CM Not useful for those not using ICD-9 CM. Barell Matrix . Why update to ICD-10? US Cost of Injury Study Multiple cause of injury death analysis

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Barell Matrix— moving to ICD-10

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  1. Barell Matrix—moving to ICD-10 Lois A. Fingerhut May 2004

  2. Barell Matrix • Conceived for injury morbidity • Codes based on ICD-9 CM • Not useful for those not using ICD-9 CM

  3. Barell Matrix • Why update to ICD-10? • US Cost of Injury Study • Multiple cause of injury death analysis • Used in both mortality and morbidity • Adaptable to different versions of clinical modifications

  4. Difficulties… • ICD-9 CM is not meant to crosswalk to ICD-10 • ICD-9 and ICD-10 injury chapters differ! • ICD-9 main axis is nature of injury • ICD-10 main axis is body region of injury • Hence translation is not straightforward • Comparability study in US not completed for injury diagnosis codes

  5. More difficulties… • Traumatic brain injury codes are particularly problematic • Morbidity codes are more detailed than mortality codes because more information is on medical record than on death certificate

  6. Nonetheless… • December 2002 I received an email from Richard Hockey in Australia • NDS-IS Nature/Body part matrix from ICD9-AM to ICD10-AM • Categories are those used in NDS-IS V2.1 developed by James Harrison • By July 2003 I produced a first draft based on ICD-10 S&T codes • Sent to Limor, Ellen, Lee, James & Richard for comment • Needs more comment!!

  7. Comments • ICD-10 is not “designed” for a single code • Perhaps pairs of codes should be used • S09.9 – Australian example: • ICD-9 854 was used in ED for any suspected intracranial head injury and its nearest equivalent in 10 is S09.9 unspecified injury of head

  8. Progress to date • Sept 2003: Ted Miller (US Cost of Injury expert) programmed SAS codes for draft matrix • US NHTSA wants a matrix (have been emailing me for more than a year!) • What to code: Entity vs Record axis- another decision • Any vs total mention (from US multiple cause file) • CDC-NCIPC wants TBI comparable codes • May 2004- presentation to NCIPC on TBI comparability

  9. What next? • Draft matrix needs more international review and comment • Mortality • 1st listed code? • Main injury? • Multiple injuries? • Morbidity • What clinical versions are being used? • Are they compatible with ICD-10?

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