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Comparative Study
. 2018 Aug;27(8):839-847.
doi: 10.1002/pds.4563. Epub 2018 Jun 26.

Early impact of the ICD-10-CM transition on selected health outcomes in 13 electronic health care databases in the United States

Catherine A Panozzo  1 , Tiffany S Woodworth  1 , Emily C Welch  1 , Ting-Ying Huang  1 , Qoua L Her  1 , Kevin Haynes  2 , Catherine Rogers  1 , Talia J Menzin  1 , Max Ehrmann  1 , Katherine E Freitas  1 , Nicole R Haug  1 , Sengwee Toh  1
Affiliations
Comparative Study

Early impact of the ICD-10-CM transition on selected health outcomes in 13 electronic health care databases in the United States

Catherine A Panozzo et al. Pharmacoepidemiol Drug Saf. 2018 Aug.

Abstract

Purpose: To describe the consistency in the frequency of 5 health outcomes across the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) and Tenth Revision, Clinical Modification (ICD-10-CM) eras in the US.

Methods: We examined the incidence of 3 acute conditions (acute myocardial infarction [AMI], angioedema, ischemic stroke) and the prevalence of 2 chronic conditions (diabetes, hypertension) during the final 5 years of the ICD-9-CM era (January 2010-September 2015) and the first 15 months of the ICD-10-CM era (October 2015-December 2016) in 13 electronic health care databases in the Sentinel System. For each health outcome reviewed during the ICD-10-CM era, we evaluated 4 definitions, including published algorithms derived from other countries, as well as simple-forward, simple-backward, and forward-backward mapping using the General Equivalence Mappings. For acute conditions, we also compared the incidence between April to December 2014 and April to December 2016.

Results: The analyses included data from approximately 172 million health plan members. While the incidence or prevalence of AMI and hypertension performed similarly across the 2 eras, the other 3 outcomes did not demonstrate consistent trends for some or all the ICD-10-CM definitions assessed.

Conclusions: When using data from both the ICD-9-CM and ICD-10-CM eras, or when using results from ICD-10-CM data to compare to results from ICD-9-CM data, researchers should test multiple ICD-10-CM outcome definitions as part of sensitivity analysis. Ongoing assessment of the impact of ICD-10-CM transition on identification of health outcomes in US electronic health care databases should occur as more data accrue.

Keywords: ICD-10-CM; acute myocardial infarction; angioedema; diabetes; hypertension; ischemic stroke; pharmacoepidemiology; sentinel.

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