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. 2023 Sep;30(1):e100746.
doi: 10.1136/bmjhci-2023-100746.

Implementer report: ICD-10 code F44.5 review for functional seizure disorder

Sana F Ali  1   2   3 , Yarden Bornovski  4 , Margaret Gopaul  1 , Daniela Galluzzo  4 , Joseph Goulet  2   3 , Stephanie Argraves  2   3 , Ebony Jackson-Shaheed  5 , Kei-Hoi Cheung  2   3 , Cynthia A Brandt  2   3 , Hamada Hamid Altalib  6   2   3
Affiliations

Implementer report: ICD-10 code F44.5 review for functional seizure disorder

Sana F Ali et al. BMJ Health Care Inform. 2023 Sep.

Abstract

Objective: The study aimed to measure the validity of International Classification of Diseases, 10th Edition (ICD-10) code F44.5 for functional seizure disorder (FSD) in the Veterans Affairs Connecticut Healthcare System electronic health record (VA EHR).

Methods: The study used an informatics search tool, a natural language processing algorithm and a chart review to validate FSD coding.

Results: The positive predictive value (PPV) for code F44.5 was calculated to be 44%.

Discussion: ICD-10 introduced a specific code for FSD to improve coding validity. However, results revealed a meager (44%) PPV for code F44.5. Evaluation of the low diagnostic precision of FSD identified inconsistencies in the ICD-10 and VA EHR systems.

Conclusion: Information system improvements may increase the precision of diagnostic coding by clinicians. Specifically, the EHR problem list should include commonly used diagnostic codes and an appropriately curated ICD-10 term list for 'seizure disorder,' and a single ICD code for FSD should be classified under neurology and psychiatry.

Keywords: BMJ Health Informatics; Decision Support Systems, Clinical; Electronic Health Records; Health Information Systems; Healthcare Common Procedure Coding System.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Frequency of FSD code F44.5 by Veterans Affairs Connecticut Healthcare System West Haven Medical Center. FSD, functional seizure disorder.
See this image and copyright information in PMC

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