Procedural coding of spinal surgeries (CPT-4 versus ICD-9-CM) and decisions regarding standards - A multicenter study
Procedural coding of spinal surgeries (CPT-4 versus ICD-9-CM) and decisions regarding standards - A multicenter study
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DOI：
10.1097/00007632-200303010-00017
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发表时间：
2003-03-01
期刊：
影响因子：
3
通讯作者：
Berg, RL
中科院分区：
文献类型：
--
作者：
Faciszewski, T;Jensen, R;Berg, RL
研究设计.应用于六个教学机构腰椎手术患者的程序编码系统（国际疾病分类，第九版，临床修订版[ICD-9-CM]与当前程序术语[CPT-4]）的比较。比较描述脊柱手术的编码系统所反映的细节。背景资料概要。管理数据库包含ICD-9-CM程序代码，这些代码来自出院摘要。这些数据库部分用于建立卫生保健利用模式和制定卫生保健政策。先前的研究已经证明ICD诊断编码的不准确性。然而，文献缺乏关于脊柱手术ICD程序编码准确性的信息。150例腰椎手术患者（年龄17-84岁）中有143例的数据完整。外科医生分配CPT-4程序代码。将这些代码与医院病历人员分配的ICD程序代码进行比较。平均而言，在六家医院中的四家，外科医生分配给患者记录的CPT代码比医院医疗记录人员分配的ICD代码更多。总的来说，CPT代码比ICD代码反映了更高的详细程度。这些发现说明了在脊柱手术病例中CPT编码比ICD编码更详细。行政数据库中包含的ICD程序代码往往低估了实际执行的外科手术的复杂性。
Study Design. A comparison of procedural coding systems (International Classification of Diseases, Ninth Revision, Clinical Modification [ICD-9-CM] vs. Current Procedural Terminology [CPT-4]) applied to lumbar spine surgery patients from six teaching institutions.Objective. To compare the detail reflected by coding systems used to describe spinal procedures.Summary of Background Data. Administrative databases contain ICD-9-CM procedural codes, which are derived from hospital discharge abstracts. These databases are used, in part, to establish health care utilization patterns and set health care policy. Previous studies have demonstrated inaccuracies in ICD diagnosis coding. However, the literature is void of information regarding the accuracy of ICD procedural coding of spine procedures.Methods. Data were complete in 143 of 150 lumbar spine surgery patients (aged 17-84 years). Surgeons assigned CPT-4 procedural codes. These codes were compared with ICD procedure codes assigned by hospital medical records staff.Results. On average, in four of six hospitals, there were more CPT codes assigned to patient records by the surgeon than ICD codes assigned by hospital medical records staff. Overall, CPT codes reflected a greater level of detail than ICD codes.Conclusions. These findings illustrate the increased detail of CPT coding over ICD coding in the spinal surgery cases reviewed. The ICD procedural codes contained in administrative databases tend to underrepresent the complexity of the surgical procedures actually performed.