TY - JOUR
T1 - Use of international classification of diseases, ninth revision, clinical modification, codes to identify inpatient fall-related injuries
AU - Waters, Teresa M.
AU - Chandler, A. Michelle
AU - Mion, Lorraine C.
AU - Daniels, Michael J.
AU - Kessler, Lori A.
AU - Miller, Stephen T.
AU - Shorr, Ronald I.
PY - 2013/12
Y1 - 2013/12
N2 - 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.
AB - 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.
KW - ICD-9-CM codes
KW - fall-related injuries
KW - hospital-acquired conditions
KW - inpatient falls
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U2 - 10.1111/jgs.12539
DO - 10.1111/jgs.12539
M3 - Article
C2 - 24329820
AN - SCOPUS:84890552533
SN - 0002-8614
VL - 61
SP - 2186
EP - 2191
JO - Journal of the American Geriatrics Society
JF - Journal of the American Geriatrics Society
IS - 12
ER -