Validation of ICD-10-CM surveillance codes for traumatic brain injury inpatient hospitalizations

James Warwick, Svetla Slavova, Joshua Bush, Julia Costich

Research output: Contribution to journalArticlepeer-review

19 Scopus citations


Objective: Using inpatient data from a 1,160-bed health system, we assessed the positive predictive value (PPV) of ICD-10-CM (International Classification of Diseases, Tenth Revision, Clinical Modification) codes included in a traumatic brain injury (TBI) surveillance definition proposed by the Centers for Disease Control and Prevention (CDC) in 2016. Methods: A random sample of 196 records with ICD-10-CM TBI codes was reviewed. The PPVs for the ICD-10-CM codes’ ability to capture true TBI cases were calculated as the percentage of records with confirmed clinical provider-documented TBI and reported with 95% confidence intervals [95%CIs]. Results: The estimated overall PPV was 74% [67.9%, 80.1%] when the codes were listed in any diagnostic field, but 91.5% [86.2%, 96.8%] when listed as the principal diagnosis. S06 codes (intracranial injury) had an overall PPV of 80.2% [74.3%, 86.1%] and 96.9% [93.3%, 100%] when listed as the principal diagnosis. S02.0-.1 codes (vault/base skull fractures) in any position without co-existing S06 codes had a PPV of 15.8% [0%, 33.2%]. Conclusions: Intracranial injury codes (S06) in any diagnostic position had a very high estimated PPV. Further research is needed to determine the utility of other codes included in the CDC proposed definition for TBI surveillance.

Original languageEnglish
Pages (from-to)1763-1770
Number of pages8
JournalBrain Injury
Issue number13-14
StatePublished - 2020

Bibliographical note

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© 2020 Taylor & Francis Group, LLC.


  • ICD-10-CM
  • Surveillance definition
  • medical record review
  • positive predictive value
  • traumatic brain injury

ASJC Scopus subject areas

  • Neuroscience (miscellaneous)
  • Developmental and Educational Psychology
  • Clinical Neurology


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