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. 2021 Oct 27:13:1011-1018.
doi: 10.2147/CLEP.S335621. eCollection 2021.

Positive Predictive Value of COVID-19 ICD-10 Diagnosis Codes Across Calendar Time and Clinical Setting

Kristine E Lynch  1   2 , Benjamin Viernes  1   2 , Elise Gatsby  1 , Scott L DuVall  1   2 , Barbara E Jones  2   3 , Tamára L Box  4 , Craig Kreisler  4 , Makoto Jones  2   3
Affiliations

Positive Predictive Value of COVID-19 ICD-10 Diagnosis Codes Across Calendar Time and Clinical Setting

Kristine E Lynch et al. Clin Epidemiol. .

Abstract

Purpose: To estimate the positive predictive value (PPV) of International Classification of Diseases, Tenth Revision (ICD-10) code U07.1, COVID-19 virus identified, in the Department of Veterans of Affairs (VA).

Patients and methods: Records of ICD-10 code U07.1 from inpatient, outpatient, and emergency/urgent care settings were extracted from VA medical record data from 4/01/2020 to 3/31/2021. A weighted, random sample of 1500 records from each quarter of the one-year observation period was reviewed by study personnel to confirm active COVID-19 infection at the time of diagnosis and classify reasons for false positive records. PPV was estimated overall and compared across clinical setting and quarters.

Results: We identified 664,406 records of U07.1. Among the 1500 reviewed, 237 were false positives (PPV: 84.2%, 95% CI: 82.4-86.0). PPV ranged from 77.7% in outpatient settings to 93.8% in inpatient settings and was 83.3% in quarter 1, 80.5% in quarter 2, 86.1% in quarter 3, and 83.6% in quarter 4. The most common reasons for false positive records were history of COVID-19 (44.3%) and orders for laboratory tests (21.5%).

Conclusion: The PPV of ICD-10 code U07.1 is low, especially in outpatient settings. Directed training may improve accuracy of coding to levels that are deemed adequate for future use in surveillance efforts.

Keywords: SARS CoV-2; administrative codes; electronic health records; validation.

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Conflict of interest statement

Dr Scott L DuVall reports grants from Anolinx, LLC, Astellas Pharma, Inc, AstraZeneca Pharmaceuticals LP, Boehringer Ingelheim International GmbH, Celgene Corporation, Eli Lilly and Company, Genentech Inc., Genomic Health, Inc., Gilead Sciences Inc., GlaxoSmithKline PLC, Innocrin Pharmaceuticals Inc., Janssen Pharmaceuticals, Inc., Kantar Health, Myriad Genetic Laboratories, Inc., Novartis International AG, and Parexel International Corporation, outside the submitted work. The author reports no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
Distribution of instances COVID-19 related ICD-10 diagnosis codes within the Department of Veterans Affairs, April 1, 2020–March 31, 2021.
See this image and copyright information in PMC

References

    1. O’Malley KJ, Cook KF, Price MD, Wildes KR, Hurdle JF, Ashton CM. Measuring diagnoses: ICD code accuracy. Health Serv Res. 2005;40(5 Pt 2):1620–1639. doi:10.1111/j.1475-6773.2005.00444.x - DOI - PMC - PubMed
    1. Centers for Disease Control and Prevention. New ICD-10-CM for the 2019 Novel Coronavirus (COVID-19), December 3; 2020. Available from: https://www.cdc.gov/nchs/data/icd/Announcement-New-ICD-code-for-coronavi.... Accessed June 11, 2021.
    1. Centers for Disease Control and Prevention. ICD-10-CM official coding and reporting guidelines: April 1, 2020 through September 30; 2020. Available from: https://www.cdc.gov/nchs/icd/icd10cm.htm. Accessed October 9, 2020.
    1. German RR, Lee LM, Horan JM, Milstein RL, Pertowski CA, Waller MN. Updated guidelines for evaluating public health surveillance systems: recommendations from the Guidelines Working Group. MMWR Recomm Rep. 2001;50(Rr–13):1–35; quiz CE31–37. - PubMed
    1. Kadri SS, Gundrum J, Warner S, et al. Uptake and accuracy of the diagnosis code for COVID-19 among US hospitalizations. JAMA Netw Open. 2020;324(24):2553–2554. - PMC - PubMed