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KMID : 0360720090220010108
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Journal of the Korean Society Traumatology
2009 Volume.22 No. 1 p.108 ~ p.115
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The Accuracy of the ICD-10 Code for Trauma Patients Visiting on Emergency Department and the Error in the ICISS
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Lee Jae-Hyuk
Sim Min-Seob
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Abstract
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Purpose: We designed a retrospective study to measure the accuracy of the ICD-10 (International Classification of Disease-10) code for trauma patients. We also analyzed the error of the ICISS (International Classification of Disease based Injury Severity Score) due to a missing or an incorrect ICD-10 code.
Methods: For the measuring the accuracy of the ICD-10 code for trauma patients in a tertiary teaching hospital’s emergency department, two board certified emergency physician performed a retrospective chart review. The ICD-10 code was classified as a main code or a sub-code. The main code was defined as the code of the main department of treatment, and the sub-code was defined as a code other than the main code. We calculated and compared two ICISS for each patient one by using both the existing code and the other by using a corrected code. We compared the proportions of severe trauma (defined as an ICISS less than 0.9) between when the existing code and the corrected code was used respectively.
Results: We reviewed the records of 4287 trauma patients who had been treated from July 2008 to November 2008. The accuracy of the main code, the sub-code of emergency department, main-code, the subcode of hospitalized patients were 97.1%, 59.8%, 98.2% and 57.0%, respectively. Total accuracy of the main and sub-code of emergency department and of hospitalized patients were 91.4% and 58.6%. The number of severe trauma patients increased from 33 to 49 when the corrected code was used in emergency department and increased from 35 to 60 in hospitalized patients.
Conclusion: The accuracy of the sub-code was lower than that of the main code. A missing or incorrect subcode could cause an error in the ICISS and in the number of patients with severe trauma.
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KEYWORD
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Trauma, ICD-10, ICISS, Accuracy
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