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Syed MH, Al-Omran M, Jacob-Brassard J, et al. ICD-10 Diagnostic Coding for Identifying Hospitalizations Related to a Diabetic Foot Ulcer. Clin Invest Med. 2021;44(4):E11-16doi: 10.25011/cim.v44i4.37592.
Syed, M. H., Al-Omran, M., Jacob-Brassard, J., Ray, J. G., Hussain, M. A., Mamdani, M., & Mestral, C. (2021). ICD-10 Diagnostic Coding for Identifying Hospitalizations Related to a Diabetic Foot Ulcer. Clinical and investigative medicine. Medecine clinique et experimentale, 44(4), E11-16. https://doi.org/10.25011/cim.v44i4.37592
Syed, Muzammil H, et al. "ICD-10 Diagnostic Coding for Identifying Hospitalizations Related to a Diabetic Foot Ulcer." Clinical and investigative medicine. Medecine clinique et experimentale vol. 44,4 (2021): E11-16. doi: https://doi.org/10.25011/cim.v44i4.37592
Syed MH, Al-Omran M, Jacob-Brassard J, Ray JG, Hussain MA, Mamdani M, Mestral C. ICD-10 Diagnostic Coding for Identifying Hospitalizations Related to a Diabetic Foot Ulcer. Clin Invest Med. 2021 Dec 31;44(4):E11-16. doi: 10.25011/cim.v44i4.37592. PMID: 34978770.
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Clin Invest Med. 2021 Dec 31;44(4):E11-16. doi: 10.25011/cim.v44i4.37592.

ICD-10 Diagnostic Coding for Identifying Hospitalizations Related to a Diabetic Foot Ulcer.

Clinical and investigative medicine. Medecine clinique et experimentale

Muzammil H Syed, Mohammed Al-Omran, Jean Jacob-Brassard, Joel G Ray, Mohamad A Hussain, Muhammad Mamdani, Charles Mestral

Affiliations

  1. Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Division of Vascular Surgery, Department of Surgery, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada. [email protected].
  2. Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Division of Vascular Surgery, Department of Surgery, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada; Diabetes Action Canada, Toronto, ON, Canada. [email protected].
  3. Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada; Divisions of General Internal Medicine and Endocrinology and Metabolism, Department of Medicine, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada. [email protected].
  4. Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada; Division of Vascular and Endovascular Surgery and the Centre for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. [email protected].
  5. Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada; Data Science and Advanced Analytics, Unity Health Toronto, Toronto, ON, Canada. [email protected].
  6. emerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Division of Vascular Surgery, Department of Surgery, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada; Diabetes Action Canada, Toronto, ON, Canada. [email protected].

PMID: 34978770 DOI: 10.25011/cim.v44i4.37592

Abstract

PURPOSE: To estimate the positive predictive value (PPV) of Canadian ICD-10 diagnostic coding for the identification of hospitalization related to a diabetic foot ulcer (DFU).

METHODS: Hospitalizations related to a neuropathic and/or ischemic DFU were identified from the Discharge Abstract Database (DAD) records of a single Canadian tertiary care hospital between April 1, 2002 and March 31, 2019. The first coding approach required a most responsible diagnosis (MRDx) code for diabetes-specific foot ulceration or gangrene (DSFUG group). Three alternative coding approaches were also considered: MRDx code for lower-limb osteomyelitis (osteomyelitis group); lower-limb ulceration (LLU group); or lower-limb atherosclerotic gangrene (atherosclerosis group)-each in conjunction with a non-MRDx DSFUG code on the same DAD record. From all eligible DAD records, random samples were drawn for each coding group. DAD records were independently compared by a masked reviewer who manually abstracted data from the entire hospital record (reference standard). The PPV and 95% CI were generated.

RESULTS: Out of 1,460 hospitalizations, a total of 300, 50, 33 and seven records were included from the DSFUG, osteomyelitis, LLU and atherosclerosis samples, respectively. Compared to the reference standard, the PPV for all 390 records was 88.5% (95% CI 84.9 to 91.5). The DSFUG group had the highest PPV (90.0%, 95% CI 86.0 to 93.2), followed by the atherosclerosis (85.7%, 95% CI 42.1 to 99.6), LLU (84.9%, 95% CI 68.1 to 94.9) and osteomyelitis (82.0%, 95% CI 68.6 to 91.4) groups.

CONCLUSION: Based on data from a Canadian tertiary care hospital, the specified coding algorithms can be used to identify and study the management and outcomes of people hospitalized with a DFU in Ontario.

Keywords: neuropathic diabetic foot ulcer; ischemic diabetic foot ulcer; diabetic foot gangrene; Discharge Abstract Database; ICD-10 diagnosis codes

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