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Inaccuracy of the International Classification of Diseases (ICD-9-CM) in identifying the diagnosis of ischemic cerebrovascular disease.

Publication ,  Journal Article
Benesch, C; Witter, DM; Wilder, AL; Duncan, PW; Samsa, GP; Matchar, DB
Published in: Neurology
September 1997

In administrative databases the International Classification of Diseases, Version 9, Clinical Modification (ICD-9-CM) is often used to identify patients with specific diagnoses. However, certain conditions may not be accurately reflected by the ICD-9 codes. We assessed the accuracy of ICD-9 coding for cerebrovascular disease by comparing ICD-9 codes in an administrative database with clinical findings ascertained from medical record abstractions. We selected patients with ICD-9 diagnostic codes of 433 through 436 (in either the primary or secondary positions) from an administrative database of patients hospitalized in five academic medical centers in 1992. Medical records of the selected patients were reviewed by trained medical abstractors, and the patients' clinical conditions during the admission (stroke, TIA, asymptomatic) were recorded, as well as any history of cerebrovascular symptoms. Results of the medical record review were compared with the ICD-9 codes from the administrative database. More than 85% of those patients with the ICD-9 code 433 were asymptomatic for the index admission. More than one-third of these asymptomatic patients did not undergo either cerebral angiography or carotid endarterectomy. For ICD-9 code 434, 85% of patients were classified as having a stroke and for ICD-9 code 435, 77% had TIAs. For code 436, 77% of patients were classified as having strokes. Limiting the identifying ICD-9 code to the primary position increased the likelihood of agreement with the medical record review. The ICD-9 coding scheme may be inaccurate in the classification of patients with ischemic cerebrovascular disease. Its limitations must be recognized in the analyses of administrative databases selected by using ICD-9 codes 433 through 436.

Duke Scholars

Published In

Neurology

DOI

ISSN

0028-3878

Publication Date

September 1997

Volume

49

Issue

3

Start / End Page

660 / 664

Location

United States

Related Subject Headings

  • Neurology & Neurosurgery
  • Neurology
  • Medical Records
  • Ischemic Attack, Transient
  • Humans
  • Forms and Records Control
  • Endarterectomy, Carotid
  • Databases, Factual
  • Classification
  • Cerebrovascular Disorders
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Benesch, C., Witter, D. M., Wilder, A. L., Duncan, P. W., Samsa, G. P., & Matchar, D. B. (1997). Inaccuracy of the International Classification of Diseases (ICD-9-CM) in identifying the diagnosis of ischemic cerebrovascular disease. Neurology, 49(3), 660–664. https://doi.org/10.1212/wnl.49.3.660
Benesch, C., D. M. Witter, A. L. Wilder, P. W. Duncan, G. P. Samsa, and D. B. Matchar. “Inaccuracy of the International Classification of Diseases (ICD-9-CM) in identifying the diagnosis of ischemic cerebrovascular disease.Neurology 49, no. 3 (September 1997): 660–64. https://doi.org/10.1212/wnl.49.3.660.
Benesch C, Witter DM, Wilder AL, Duncan PW, Samsa GP, Matchar DB. Inaccuracy of the International Classification of Diseases (ICD-9-CM) in identifying the diagnosis of ischemic cerebrovascular disease. Neurology. 1997 Sep;49(3):660–4.
Benesch, C., et al. “Inaccuracy of the International Classification of Diseases (ICD-9-CM) in identifying the diagnosis of ischemic cerebrovascular disease.Neurology, vol. 49, no. 3, Sept. 1997, pp. 660–64. Pubmed, doi:10.1212/wnl.49.3.660.
Benesch C, Witter DM, Wilder AL, Duncan PW, Samsa GP, Matchar DB. Inaccuracy of the International Classification of Diseases (ICD-9-CM) in identifying the diagnosis of ischemic cerebrovascular disease. Neurology. 1997 Sep;49(3):660–664.

Published In

Neurology

DOI

ISSN

0028-3878

Publication Date

September 1997

Volume

49

Issue

3

Start / End Page

660 / 664

Location

United States

Related Subject Headings

  • Neurology & Neurosurgery
  • Neurology
  • Medical Records
  • Ischemic Attack, Transient
  • Humans
  • Forms and Records Control
  • Endarterectomy, Carotid
  • Databases, Factual
  • Classification
  • Cerebrovascular Disorders