Development and Validation of an Algorithm to Classify as Equivalent the Procedures in ICD-10-PCS That Differ Only by Laterality

Richard H. Epstein, Franklin Dexter, Liam O'Neill

Research output: Contribution to journalArticleResearchpeer-review

Abstract

BACKGROUND: The switch from International Classification of Diseases, Ninth Revision, Clinical Modification to International Classification of Diseases, Tenth Revision, Procedure Coding System (ICD-10-PCS) for coding of inpatient procedures in the United States increased the number of procedural codes more than 19-fold, in large part due to the addition of laterality. We examined ICD-10-PCS codes for pairs of mirror-image procedures that are surgically equivalent. METHODS: We developed an algorithm in structured query language (SQL) to identify ICD-10-PCS codes differing only by laterality. We quantified the impact of laterality on the number of commonly performed major therapeutic procedures (ie, surgical diversity) using 2 quarters of discharge abstracts from Texas. RESULTS: Of the 75,789 ICD-10-PCS codes from federal fiscal year 2017, 16,839 (22.3%) pairs differed only by laterality (with each pair contributing 2 codes). With the combining of equivalent codes, diversity in the state of Texas decreased from 78.2 to 74.1 operative procedures (95% confidence interval, 5.1 to -3.1; P < .001). CONCLUSIONS: Our algorithm identifies ICD-10-PCS codes that differ only by laterality. However, laterality had a small effect on surgical diversity among major therapeutic procedures. Our SQL code and the lookup table will be useful for all US inpatient analyses of ICD-10-PCS surgical data, because combining procedures differing only by laterality will often be desired.

Original languageEnglish
Pages (from-to)1138-1144
Number of pages7
JournalAnesthesia and analgesia
Volume128
Issue number6
DOIs
StatePublished - 1 Jun 2019

Fingerprint

International Classification of Diseases
Inpatients
Language
Operative Surgical Procedures
Confidence Intervals
Therapeutics

Cite this

Epstein, Richard H. ; Dexter, Franklin ; O'Neill, Liam. / Development and Validation of an Algorithm to Classify as Equivalent the Procedures in ICD-10-PCS That Differ Only by Laterality. In: Anesthesia and analgesia. 2019 ; Vol. 128, No. 6. pp. 1138-1144.
@article{4d8d2b4ff435487187922f16c3cd040f,
title = "Development and Validation of an Algorithm to Classify as Equivalent the Procedures in ICD-10-PCS That Differ Only by Laterality",
abstract = "BACKGROUND: The switch from International Classification of Diseases, Ninth Revision, Clinical Modification to International Classification of Diseases, Tenth Revision, Procedure Coding System (ICD-10-PCS) for coding of inpatient procedures in the United States increased the number of procedural codes more than 19-fold, in large part due to the addition of laterality. We examined ICD-10-PCS codes for pairs of mirror-image procedures that are surgically equivalent. METHODS: We developed an algorithm in structured query language (SQL) to identify ICD-10-PCS codes differing only by laterality. We quantified the impact of laterality on the number of commonly performed major therapeutic procedures (ie, surgical diversity) using 2 quarters of discharge abstracts from Texas. RESULTS: Of the 75,789 ICD-10-PCS codes from federal fiscal year 2017, 16,839 (22.3{\%}) pairs differed only by laterality (with each pair contributing 2 codes). With the combining of equivalent codes, diversity in the state of Texas decreased from 78.2 to 74.1 operative procedures (95{\%} confidence interval, 5.1 to -3.1; P < .001). CONCLUSIONS: Our algorithm identifies ICD-10-PCS codes that differ only by laterality. However, laterality had a small effect on surgical diversity among major therapeutic procedures. Our SQL code and the lookup table will be useful for all US inpatient analyses of ICD-10-PCS surgical data, because combining procedures differing only by laterality will often be desired.",
author = "Epstein, {Richard H.} and Franklin Dexter and Liam O'Neill",
year = "2019",
month = "6",
day = "1",
doi = "10.1213/ANE.0000000000003340",
language = "English",
volume = "128",
pages = "1138--1144",
journal = "Anesthesia and Analgesia",
issn = "0003-2999",
publisher = "Lippincott Williams and Wilkins Ltd.",
number = "6",

}

Development and Validation of an Algorithm to Classify as Equivalent the Procedures in ICD-10-PCS That Differ Only by Laterality. / Epstein, Richard H.; Dexter, Franklin; O'Neill, Liam.

In: Anesthesia and analgesia, Vol. 128, No. 6, 01.06.2019, p. 1138-1144.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Development and Validation of an Algorithm to Classify as Equivalent the Procedures in ICD-10-PCS That Differ Only by Laterality

AU - Epstein, Richard H.

AU - Dexter, Franklin

AU - O'Neill, Liam

PY - 2019/6/1

Y1 - 2019/6/1

N2 - BACKGROUND: The switch from International Classification of Diseases, Ninth Revision, Clinical Modification to International Classification of Diseases, Tenth Revision, Procedure Coding System (ICD-10-PCS) for coding of inpatient procedures in the United States increased the number of procedural codes more than 19-fold, in large part due to the addition of laterality. We examined ICD-10-PCS codes for pairs of mirror-image procedures that are surgically equivalent. METHODS: We developed an algorithm in structured query language (SQL) to identify ICD-10-PCS codes differing only by laterality. We quantified the impact of laterality on the number of commonly performed major therapeutic procedures (ie, surgical diversity) using 2 quarters of discharge abstracts from Texas. RESULTS: Of the 75,789 ICD-10-PCS codes from federal fiscal year 2017, 16,839 (22.3%) pairs differed only by laterality (with each pair contributing 2 codes). With the combining of equivalent codes, diversity in the state of Texas decreased from 78.2 to 74.1 operative procedures (95% confidence interval, 5.1 to -3.1; P < .001). CONCLUSIONS: Our algorithm identifies ICD-10-PCS codes that differ only by laterality. However, laterality had a small effect on surgical diversity among major therapeutic procedures. Our SQL code and the lookup table will be useful for all US inpatient analyses of ICD-10-PCS surgical data, because combining procedures differing only by laterality will often be desired.

AB - BACKGROUND: The switch from International Classification of Diseases, Ninth Revision, Clinical Modification to International Classification of Diseases, Tenth Revision, Procedure Coding System (ICD-10-PCS) for coding of inpatient procedures in the United States increased the number of procedural codes more than 19-fold, in large part due to the addition of laterality. We examined ICD-10-PCS codes for pairs of mirror-image procedures that are surgically equivalent. METHODS: We developed an algorithm in structured query language (SQL) to identify ICD-10-PCS codes differing only by laterality. We quantified the impact of laterality on the number of commonly performed major therapeutic procedures (ie, surgical diversity) using 2 quarters of discharge abstracts from Texas. RESULTS: Of the 75,789 ICD-10-PCS codes from federal fiscal year 2017, 16,839 (22.3%) pairs differed only by laterality (with each pair contributing 2 codes). With the combining of equivalent codes, diversity in the state of Texas decreased from 78.2 to 74.1 operative procedures (95% confidence interval, 5.1 to -3.1; P < .001). CONCLUSIONS: Our algorithm identifies ICD-10-PCS codes that differ only by laterality. However, laterality had a small effect on surgical diversity among major therapeutic procedures. Our SQL code and the lookup table will be useful for all US inpatient analyses of ICD-10-PCS surgical data, because combining procedures differing only by laterality will often be desired.

UR - http://www.scopus.com/inward/record.url?scp=85058683950&partnerID=8YFLogxK

U2 - 10.1213/ANE.0000000000003340

DO - 10.1213/ANE.0000000000003340

M3 - Article

VL - 128

SP - 1138

EP - 1144

JO - Anesthesia and Analgesia

JF - Anesthesia and Analgesia

SN - 0003-2999

IS - 6

ER -