| Measuring diagnoses: ICD code accuracy. | |
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MedLine Citation:
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PMID: 16178999 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To examine potential sources of errors at each step of the described inpatient International Classification of Diseases (ICD) coding process. DATA SOURCES/STUDY SETTING: The use of disease codes from the ICD has expanded from classifying morbidity and mortality information for statistical purposes to diverse sets of applications in research, health care policy, and health care finance. By describing a brief history of ICD coding, detailing the process for assigning codes, identifying where errors can be introduced into the process, and reviewing methods for examining code accuracy, we help code users more systematically evaluate code accuracy for their particular applications. STUDY DESIGN/METHODS: We summarize the inpatient ICD diagnostic coding process from patient admission to diagnostic code assignment. We examine potential sources of errors at each step and offer code users a tool for systematically evaluating code accuracy. PRINCIPLE FINDINGS: Main error sources along the "patient trajectory" include amount and quality of information at admission, communication among patients and providers, the clinician's knowledge and experience with the illness, and the clinician's attention to detail. Main error sources along the "paper trail" include variance in the electronic and written records, coder training and experience, facility quality-control efforts, and unintentional and intentional coder errors, such as misspecification, unbundling, and upcoding. CONCLUSIONS: By clearly specifying the code assignment process and heightening their awareness of potential error sources, code users can better evaluate the applicability and limitations of codes for their particular situations. ICD codes can then be used in the most appropriate ways. |
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Authors:
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Kimberly J O'Malley; Karon F Cook; Matt D Price; Kimberly Raiford Wildes; John F Hurdle; Carol M Ashton |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S. |
Journal Detail:
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Title: Health services research Volume: 40 ISSN: 0017-9124 ISO Abbreviation: Health Serv Res Publication Date: 2005 Oct |
Date Detail:
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Created Date: 2005-09-23 Completed Date: 2005-11-29 Revised Date: 2009-11-18 |
Medline Journal Info:
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Nlm Unique ID: 0053006 Medline TA: Health Serv Res Country: United States |
Other Details:
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Languages: eng Pagination: 1620-39 Citation Subset: IM |
Affiliation:
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Pearson Educational Mearsurement, Austin, TX 78758, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Data Collection
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methods* Health Services Research / methods* Humans International Classification of Diseases* Reproducibility of Results |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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