TY - JOUR
T1 - Multi-site medical record review for validation of intentional self-harm coding in emergency departments
AU - Gabella, Barbara A.
AU - Hume, Beth
AU - Li, Linda
AU - Mabida, Marianne
AU - Costich, Julia
N1 - Publisher Copyright:
© 2022, The Author(s).
PY - 2022/12
Y1 - 2022/12
N2 - Background: Codes in the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM), are used for injury surveillance, including surveillance of intentional self-harm, as they appear in administrative billing records. This study estimated the positive predictive value of ICD-10-CM codes for intentional self-harm in emergency department (ED) billing records for patients aged 10 years and older who did not die and were not admitted to an inpatient medical service. Methods: The study team in Maryland, Colorado, and Massachusetts selected all or a random sample of ED billing records with an ICD-10-CM code for intentional self-harm (specific codes that began with X71-X83, T36-T65, T71, T14.91). Positive predictive value (PPV) was determined by the number and percentage of records with a physician diagnosis of intentional self-harm, based on a retrospective review of the original medical record. Results: The estimated PPV for the codes’ capture of intentional self-harm based on physician diagnosis in the original medical record was 89.8% (95% CI 85.0–93.4) for Maryland records, 91.9% (95% CI 87.7–95.0) for Colorado records, and 97.3% (95% CI 95.1–98.7) for Massachusetts records. Conclusion: Given the high PPV of the codes, epidemiologists can use the codes for public health surveillance of intentional self-harm treated in the ED using ICD-10-CM coded administrative billing records. However, these codes and related variables in the billing database cannot definitively distinguish between suicidal and non-suicidal intentional self-harm.
AB - Background: Codes in the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM), are used for injury surveillance, including surveillance of intentional self-harm, as they appear in administrative billing records. This study estimated the positive predictive value of ICD-10-CM codes for intentional self-harm in emergency department (ED) billing records for patients aged 10 years and older who did not die and were not admitted to an inpatient medical service. Methods: The study team in Maryland, Colorado, and Massachusetts selected all or a random sample of ED billing records with an ICD-10-CM code for intentional self-harm (specific codes that began with X71-X83, T36-T65, T71, T14.91). Positive predictive value (PPV) was determined by the number and percentage of records with a physician diagnosis of intentional self-harm, based on a retrospective review of the original medical record. Results: The estimated PPV for the codes’ capture of intentional self-harm based on physician diagnosis in the original medical record was 89.8% (95% CI 85.0–93.4) for Maryland records, 91.9% (95% CI 87.7–95.0) for Colorado records, and 97.3% (95% CI 95.1–98.7) for Massachusetts records. Conclusion: Given the high PPV of the codes, epidemiologists can use the codes for public health surveillance of intentional self-harm treated in the ED using ICD-10-CM coded administrative billing records. However, these codes and related variables in the billing database cannot definitively distinguish between suicidal and non-suicidal intentional self-harm.
KW - ICD-10-CM
KW - Intentional self-harm
KW - Population surveillance
KW - Suicide
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U2 - 10.1186/s40621-022-00380-y
DO - 10.1186/s40621-022-00380-y
M3 - Article
AN - SCOPUS:85131953998
VL - 9
JO - Injury Epidemiology
JF - Injury Epidemiology
IS - 1
M1 - 16
ER -