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Strengths and limitations of International Classification of Disease Ninth Revision Clinical Modification codes in defining cervical spine surgery. Spine (Phila Pa 1976) 2011 Jan 01;36(1):E38-44 PMID: 20975624

Pubmed ID

20975624

DOI

10.1097/BRS.0b013e3181d273f6

Abstract

STUDY DESIGN: Retrospective study.

OBJECTIVE: To evaluate the sensitivity and specificity of International Classification of Disease Ninth Revision Clinical Modification (ICD9-CM) hospital discharge codes to define degenerative cervical spine surgery in comparison to patient operative notes in the medical record.

SUMMARY OF BACKGROUND DATA: Population-based studies of spine surgery have often relied on administrative databases as a primary information source, but little is known about the validity of using ICD9-CM codes to identify these operations.

METHODS: We performed a retrospective study comparing ICD9-CM billing codes to patient operative notes, the gold standard, for patients undergoing spine surgery in 2006 at a single academic center.

RESULTS: We identified 1090 procedures of which 265 were categorized as cervical spine surgery for degenerative indications based on the operative notes. Compared to operative notes, our ICD9-CM algorithm had high sensitivity and specificity for selecting surgery at the cervical spine level and cervical spine surgery for degenerative indications. Categorization of cases by procedure had high sensitivity and specificity for fusion and surgical approach (>95%). Categorization of cases by primary diagnosis was generally less accurate. Cervical spondylosis with myelopathy was the most sensitive primary diagnosis. Categorization of cases by procedure had high sensitivity and specificity for fusion and surgical approach (≥96%). However, diagnoses such as herniated disc and procedures such as laminectomy had low sensitivity but high specificity.

CONCLUSION: The use of our ICD9-CM algorithm to define spine surgery at the cervical spine level, and degenerative cervical spine surgery is highly accurate. Although specific diagnoses codes are mostly insensitive, an ICD9-CM algorithm can be used to study these procedures with reasonable precision.

Author List

Wang MC, Laud PW, Macias M, Nattinger AB

Authors

Purushottam W. Laud PhD Professor in the Institute for Health and Equity department at Medical College of Wisconsin
Ann B. Nattinger MD, MPH Associate Provost, Professor in the Medicine department at Medical College of Wisconsin
Marjorie Wang MD Chief, Professor in the Neurosurgery department at Medical College of Wisconsin




Scopus

2-s2.0-78751590974   23 Citations

MESH terms used to index this publication - Major topics in bold

Academic Medical Centers
Algorithms
Cervical Vertebrae
Data Mining
Databases as Topic
Humans
International Classification of Diseases
Medical Records
Orthopedic Procedures
Patient Discharge
Reproducibility of Results
Retrospective Studies
Sensitivity and Specificity
Spinal Diseases
Wisconsin
jenkins-FCD Prod-332 f92a19b0ec5e8e1eff783fac390ec127e367c2b5