Assessing validity of ICD-9-CM and ICD-10 administrative data in recording clinical conditions in a unique dually coded database.
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OBJECTIVE: The goal of this study was to assess the validity of the International Classification of Disease, 10th Version (ICD-10) administrative hospital discharge data and to determine whether there were improvements in the validity of coding for clinical conditions compared with ICD-9 Clinical Modification (ICD-9-CM) data. METHODS: We reviewed 4,008 randomly selected charts for patients admitted from January 1 to June 30, 2003 at four teaching hospitals in Alberta, Canada to determine the presence or absence of 32 clinical conditions and to assess the agreement between ICD-10 data and chart data. We then re-coded the same charts using ICD-9-CM and determined the agreement between the ICD-9-CM data and chart data for recording those same conditions. The accuracy of ICD-10 data relative to chart data was compared with the accuracy of ICD-9-CM data relative to chart data. RESULTS: Sensitivity values ranged from 9.3 to 83.1 percent for ICD-9-CM and from 12.7 to 80.8 percent for ICD-10 data. Positive predictive values ranged from 23.1 to 100 percent for ICD-9-CM and from 32.0 to 100 percent for ICD-10 data. Specificity and negative predictive values were consistently high for both ICD-9-CM and ICD-10 databases. Of the 32 conditions assessed, ICD-10 data had significantly higher sensitivity for one condition and lower sensitivity for seven conditions relative to ICD-9-CM data. The two databases had similar sensitivity values for the remaining 24 conditions. CONCLUSIONS: The validity of ICD-9-CM and ICD-10 administrative data in recording clinical conditions was generally similar though validity differed between coding versions for some conditions. The implementation of ICD-10 coding has not significantly improved the quality of administrative data relative to ICD-9-CM. Future assessments like this one are needed because the validity of ICD-10 data may get better as coders gain experience with the new coding system. (+info)
Essentials of skin laceration repair.
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Skin laceration repair is an important skill in family medicine. Sutures, tissue adhesives, staples, and skin-closure tapes are options in the outpatient setting. Physicians should be familiar with various suturing techniques, including simple, running, and half-buried mattress (corner) sutures. Although suturing is the preferred method for laceration repair, tissue adhesives are similar in patient satisfaction, infection rates, and scarring risk in low skin-tension areas and may be more cost-effective. The tissue adhesive hair apposition technique also is effective in repairing scalp lacerations. The sting of local anesthesia injections can be lessened by using smaller gauge needles, administering the injection slowly, and warming or buffering the solution. Studies have shown that tap water is safe to use for irrigation, that white petrolatum ointment is as effective as antibiotic ointment in postprocedure care, and that wetting the wound as early as 12 hours after repair does not increase the risk of infection. Patient education and appropriate procedural coding are important after the repair. (+info)
Churning: the association between health care transitions and feeding tube insertion for nursing home residents with advanced cognitive impairment.
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Current procedural terminology coding in electrophysiology: focus on 2009 updates.
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This article highlights the major changes in the current procedural terminology codes (CPT codes) that were announced by the American Medical Association in January 2009. These new CPT codes were developed to more accurately reflect current cardiac device monitoring capabilities, long-distance telemetry and remote interrogation as well as follow-up practices. Some of these new code sets are structured differently than the CPT codes that they replace. Specifically, the new codes for remote monitoring do not have separate professional (-26) and technical components (-TC) applied to an individual code. Instead, the new remote monitoring codes have separate CPT codes that represent the professional and technical components. The new device programming codes are generally defined by the number of leads, rather than the type of generator. Also, the period of time included in the specific type of service is indicated as per encounter, 30 or 90 days. Furthermore, two new periprocedural device evaluation and programming codes have been introduced. (+info)
Accuracy and complexities of using automated clinical data for capturing chemotherapy administrations: implications for future research.
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Exploratory study of radiology coding in health information management practice.
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An exploratory study was undertaken to determine the role and practice issues of radiology coding in health information management (HIM) practice. The study sought to identify the challenges of radiology coding and the solutions implemented to address these challenges. A self-report survey was sent to 828 American Health Information Management Association (AHIMA) members identified as directors, managers, or supervisors of HIM departments and/or coding. Two hundred seventy-eight surveys were used for data analysis purposes. Sites reported that on average they have 3.4 coders devoted to radiology coding who code an average of 4,245 reports per month. Productivity standards varied by exam type ranging from 7 (interventional radiology) to 31 (diagnostic) exams coded per hour. Diagnosis codes were assigned most frequently for diagnostic, ultrasound/nuclear, MRI/CT, and mammography exams, while diagnosis and procedural codes were assigned more frequently for interventional radiology exams. The need for education specifically focused on interventional radiology coding was identified along with other issues affecting the quality of radiology coding. Suggested solutions to challenges of radiology coding such as establishing a good working relationship with physicians, radiology, and charge description master (CDM) departments were suggested. (+info)
Pay for performance: will dentistry follow?
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