Improved Coding of Postoperative Deep Vein Thrombosis and Pulmonary Embolism in Administrative Data (AHRQ Patient Safety Indicator 12) After Introduction of New ICD-9-CM Diagnosis Codes

• DOI: 10.1097/mlr.0b013e318287d59e
• Publication Date: 2013-04-02T15:36:53Z
• Authors: Banafsheh Sadeghi; Richard H. White; Gregory Maynard; Patricia Zrelak; Amy Strater; Laurie Hensley; Julie Cerese; Patrick Romano
• Keywords: Diagnosis code; Data extraction

Symptomatic venous thromboembolism is a common postoperative complication. The Agency for Healthcare Research and Quality (AHRQ) has developed Patient Safety Indicator 12 to assist hospitals, payers, other stakeholders identify patients who experienced this complication.To determine whether newly created recently redefined ICD-9-CM codes improved the criterion validity of 12, based on new samples records dated after October 2009.Two sources data were used: (1) UHC retrospective case-control study risk factors acute symptomatic occurring within 90 days total knee arthroplasty in teaching hospitals; (2) chart abstraction by volunteer hospitals participating Validation Pilot Project AHRQ.In sample, positive predictive value (PPV) was 99% (125/126) negative 99.4% (460/463). In AHRQ overall PPV 81% (126/156).The both shows substantial improvement compared with previously reported PPVs 43%-48%, suggesting that changes code architecture better coding guidance can improve usefulness coded data.