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. 2022 Jun;163(6):2232-2239.
doi: 10.1016/j.jtcvs.2021.10.015. Epub 2021 Oct 21.

A mapping algorithm for International Classification of Diseases 10th Revision codes for congenital heart surgery benchmark procedures

Farhan Zafar  1 , Philip Allen  2 , Roosevelt Bryant 3rd  3 , James S Tweddell  4 , Hani K Najm  5 , Brett R Anderson  6 , Tara Karamlou  5
Affiliations

A mapping algorithm for International Classification of Diseases 10th Revision codes for congenital heart surgery benchmark procedures

Farhan Zafar et al. J Thorac Cardiovasc Surg. 2022 Jun.

Abstract

Background: Administrative billing data are critical to many initiatives in congenital heart surgery. Mapping algorithms for International Classification of Disease, 10th Revision diagnosis and procedure codes to clinical registry procedure definitions will allow identification of surgical cases and account for patient and procedural factors within administrative data. Our objectives were to develop mapping logic to crosswalk International Classification of Disease, 10th Revision procedure codes to 10 Society of Thoracic Surgeons Congenital Heart Surgery Database benchmark and beta-test the algorithm.

Methods: Patients undergoing Society of Thoracic Surgeons Congenital Heart Surgery Database benchmark procedures from 2015 to 2019 were identified and served as the gold standard. Cases were linked on direct identifiers to cases from the Pediatric Health Information System Database. Two independent teams developed International Classification of Disease, 10th Revision-based algorithms for cases capture. Algorithms were compared and iteratively refined to optimize sensitivity and specificity. Operative mortalities for cases identified in the administrative versus registry data were compared.

Results: Overall sensitivity was 91% and specificity was 99% for capture of benchmark operations using International Classification of Diseases 10th Revision codes. Sensitivity was more than 90% in identifying 6 of the 10 individual benchmark procedures and more than 98% sensitive in identifying Fontan, Glenn, and arterial switch with ventricular septal defect procedures. Specificity was more than 98% for all benchmark operations. There were no statistical differences in operative mortality between cases identified in the administrative versus the registry data.

Conclusions: Novel mapping algorithm for International Classification of Disease, 10th Revision procedure codes enables identification of congenital heart benchmark procedures within administrative billing data. This crosswalk facilitates population-based congenital heart surgical research and quality assessment.

Keywords: administrative data; benchmark operations; congenital heart surgery ICD-10 procedure codes.

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Conflict of interest statement

Conflict of Interest Statement

The authors reported no conflicts of interest.

The Journal policy requires editors and reviewers to disclose conflicts of interest and to decline handling or reviewing manuscripts for which they may have a conflict of interest. The editors and reviewers of this article have no conflicts of interest.

Figures

FIGURE 1.
FIGURE 1.
Examples of the 2 algorithms (TOF repair and complete atrioventricular canal repair) with relevant ICD-10 diagnosis and procedure codes; a list of all 10 algorithms is provided in Online Data Supplement. TOF, Tetralogy of Fallot; CAVC, complete atrioventicular canal; PV, pulmonary valve; DORV, double outlet right ventricle; VSD, ventricular septal defect; AVSD, atrioventricular septal defect; ICD-10, International Classification of Disease, 10th Revision; ASD, atrial septal defect; MV, mitral valve; TV, tricuspid valve; ASO, arterial switch operation; LV, left ventricle; PA, pulmonary artery; BT, Blalock-Taussig.
FIGURE 2.
FIGURE 2.
Operative mortality rate (95% confidence interval) for the benchmark operations in administrative data (algorithm defined) versus locally held Cincinnati’s Society of Thoracic Surgeons data. A similar mortality rate was noted in administrative data, further validating the algorithm. VSD, Ventricular septal defect; TOF, tetralogy of Fallot; AVC, atrioventricular canal; ASO, arterial switch operation; ICD, International Classification of Disease; CI, confidence interval; STS, Society of Thoracic Surgeons.
FIGURE 3.
FIGURE 3.
Discharge mortality rate (95% confidence interval) for the benchmark operations (24,714) in the entire PHIS cohort (October 2015 to December 2019; 24,493 admissions) identified using the mapping algorithm. This demonstrates the potential cohort size and comparable morality rate in an administrative dataset. VSD, Ventricular septal defect; TOF, tetralogy of Fallot; AVC, atrioventricular canal; ASO, arterial switch operation; ICD, International Classification of Disease; CI, confidence interval.
FIGURE 4.
FIGURE 4.
Summary of the data source and key methods. Left lower dot whisker plot represents similar inpatient morality rate (95% confidence interval) for the benchmark operations in administrative data (algorithm defined) versus locally held Cincinnati’s Society of Thoracic Surgeons data. Right lower table represents the total number of case capture for all benchmark operations in an administrative data (2015–2019). ICD-10, International Classification of Disease, 10th Revision; PHIS, Pediatric Health Information System; STS, Society of Thoracic Surgeons; VSD, Ventricular septal defect; TOF, tetralogy of Fallot; AVC, atrioventricular canal; ASO, arterial switch operation; CI, confidence interval; CAVSD, complete atrioventricular septal defect.
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References

    1. Jacobs JP, Pasquali SK, Austin E, Gaynor JW, Backer C, Hirsch-Romano JC, et al. Linking the congenital heart surgery databases of the Society of Thoracic Surgeons and the Congenital Heart Surgeons’ Society: part 1–rationale and methodology. World J Pediatr Congenit Heart Surg. 2014;5:256–71. - PMC - PubMed
    1. Welke KF, Pasquali SK, Lin P, Backer CL, Overman DM, Romano JC, et al. Hospital distribution and patient travel patterns for congenital cardiac surgery in the United States. Ann Thorac Surg. 2019;107:574–81. - PubMed
    1. Jenkins KJ, Gauvreau K, Newburger JW, Spray TL, Moller JH, Iezzoni LI. Consensus-based method for risk adjustment for surgery for congenital heart disease. J Thorac Cardiovasc Surg. 2002;123:110–8. - PubMed
    1. Jacobs JP, Mayer JE Jr, Pasquali SK, Hill KD, Overman DM, St Louis JD, et al. The Society of Thoracic Surgeons congenital heart surgery database: 2019 update on outcomes and quality. Ann Thorac Surg. 2019;107:691–704. - PubMed
    1. Jacobs JP, O’Brien SM, Pasquali SK, Jacobs ML, Lacour-Gayet FG, Tchervenkov CI, et al. Variation in outcomes for benchmark operations: an analysis of the Society of Thoracic Surgeons congenital heart surgery database. Ann Thorac Surg. 2011;92:2184–91. - PMC - PubMed

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