Use of international classification of diseases, ninth revision, clinical modification, codes to identify inpatient fall-related injuries

Teresa M. Waters, A. Michelle Chandler, Lorraine C. Mion, Michael J. Daniels, Lori A. Kessler, Stephen T. Miller, Ronald I. Shorr

Research output: Contribution to journalArticlepeer-review

9 Scopus citations

Abstract

Objectives: To compare falls and fall-related injuries that a fall evaluator or hospital incident report identified with injuries identified according to discharge International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes for the same set of inpatient episodes of care. Design: Prospective, descriptive study. Setting: Sixteen adult general medical and surgical units in a major urban teaching hospital. Participants: All adults who sustained a fall with injury during a 5-year period (380 falls with injury). Measurements: Falls that a fall evaluator or hospital incident report identified were classified according to their injury severity. Discharge abstracts provided diagnosis codes (ICD-9-CM) for the discharge, including fall-related injury codes. Results: Three hundred forty-three inpatient falls with injury (90.2%) resulted in temporary harm to the individual; the remaining 37 falls (9.8%) resulted in more-serious harm. Sixteen of the 37 falls with injury extending hospitalization or resulting in death were identified using Centers for Medicare and Medicaid Services (CMS)-targeted injury code ranges combined with present-on-admission indicators. Of the 21 falls with injury that were not identified, nine (42.9%) lacked documentation of any injury, and seven (33.3%) identified other injuries outside the CMS-targeted injury code ranges. Conclusion: The CMS-targeted ICD-9-CM codes used to identify fall-related injuries in claims data do not always detect the most-serious falls.

Original languageEnglish
Pages (from-to)2186-2191
Number of pages6
JournalJournal of the American Geriatrics Society
Volume61
Issue number12
DOIs
StatePublished - Dec 2013

Keywords

  • ICD-9-CM codes
  • fall-related injuries
  • hospital-acquired conditions
  • inpatient falls

ASJC Scopus subject areas

  • Geriatrics and Gerontology

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