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Validity of ICD-10 codes for COVID-19 patients with hospital admissions or ED visits in Canada: a retrospective cohort study
Copyright policy )Validity of ICD-10 codes for COVID-19 patients with hospital admissions or ED visits in Canada: a retrospective cohort study
ObjectiveTo evaluate the validity of COVID-19 International Classification of Diseases, 10th Revision (ICD-10) codes and their combinations.DesignRetrospective cohort study.SettingAcute care hospitals and emergency departments (EDs) in Alberta, Canada.ParticipantsPatients who were admitted to hospital or presented to an ED in Alberta, as captured by local administrative databases between 1 March 2020 and 28 February 2021, who had a positive COVID-19 test and/or a COVID-19-related ICD-10 code.Main outcome measuresThe sensitivity, positive predictive value (PPV) and 95% CIs for ICD-10 codes were computed. Stratified analysis on age group, sex, symptomatic status, mechanical ventilation, hospital type, patient intensive care unit (ICU) admission, discharge status and season of pandemic were conducted.ResultsTwo overlapping subsets of the study population were considered: those who had a positive COVID-19 test (cohort A, for estimating sensitivity) and those who had a COVID-19-related ICD-10 code (cohort B, for estimating PPV). Cohort A included 17 979 ED patients and 6477 inpatients while cohort B included 33 675 ED patients and 18 746 inpatients. Of inpatients, 9.5% in cohort A and 8.1% in cohort B received mechanical ventilation. Over 13% of inpatients were admitted to ICU. The length of hospital stay was 6 days (IQR: 3–14) for cohort A and 8 days (IQR: 3–19) for cohort B. In-hospital mortality was 15.9% and 38.8% for cohort A and B, respectively. The sensitivity for ICD-10 code U07.1 (COVID-19, virus identified) was 82.5% (81.8%–83.2%) with a PPV of 93.1% (92.6%–93.6%). The combination of U07.1 and U07.3 (multisystem inflammatory syndrome associated with COVID-19) had a sensitivity of 82.5% (81.9%–83.2%) and PPV of 92.9% (92.4%–93.4%).ConclusionsIn Alberta, ICD-10 COVID-19 codes (U07.1 and U07.3) were coded well with high validity. This indicates administrative data can be used for COVID-19 research and pandemic management purposes.
- University of Calgary Canada
- Alberta Health Services Canada
validation, 2474, SARS-CoV-2, R, COVID-19, General Medicine, sensitivity, Hospitals, Alberta, Cohort Studies, ICD-10, International Classification of Diseases, positive predictive value, Medicine, Humans, Health Services Research, 1506, 1704, Retrospective Studies
validation, 2474, SARS-CoV-2, R, COVID-19, General Medicine, sensitivity, Hospitals, Alberta, Cohort Studies, ICD-10, International Classification of Diseases, positive predictive value, Medicine, Humans, Health Services Research, 1506, 1704, Retrospective Studies
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1 Coronavirus (COVID-19) data: World Health organization, 2021. Available: https://www.who.int/data
2 Ozili PK, Arun T. Spillover of COVID-19: impact on the global economy. SSRN Electronic Journal 2020;10.
3 Galea S, Merchant RM, Lurie N. The mental health consequences of COVID-19 and physical distancing: the need for prevention and early intervention. JAMA Intern Med 2020;180:817-8.
4 Xu B, Gutierrez B, Mekaru S, et al. Epidemiological data from the COVID-19 outbreak, real-time case information. Sci Data 2020;7:1-6.
5 Weible CM, Nohrstedt D, Cairney P, et al. COVID-19 and the policy sciences: initial reactions and perspectives. Policy Sci 2020;53:225-41. [OpenAIRE]
6 Hale T, Petherick A, Phillips T. Variation in government responses to COVID-19. Blavatnik school of government working paper 2020;31:2020-11.
7 World Health Organization. Emergency use ICD codes for COVID-19 disease outbreak 2020.
8 Information CIfH. ICD-10-CA coding direction for COVID-19. Ottawa; 2021.
9 Bhatt AS, McElrath EE, Claggett BL, et al. Accuracy of ICD-10 diagnostic codes to identify COVID-19 among hospitalized patients. J Gen Intern Med 2021;36:1-14.
10 Kadri SS, Gundrum J, Warner S, et al. Uptake and accuracy of the diagnosis code for COVID-19 among US hospitalizations. JAMA 2020;324:2553-4.
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citations This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).12 popularity This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.Top 10% influence This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).Average impulse This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.Top 10% citations This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).12 popularity This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.Top 10% influence This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).Average impulse This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.Top 10%
Citations provided by BIP!Popularity provided by BIP!- University of Calgary Canada
- Alberta Health Services Canada
ObjectiveTo evaluate the validity of COVID-19 International Classification of Diseases, 10th Revision (ICD-10) codes and their combinations.DesignRetrospective cohort study.SettingAcute care hospitals and emergency departments (EDs) in Alberta, Canada.ParticipantsPatients who were admitted to hospital or presented to an ED in Alberta, as captured by local administrative databases between 1 March 2020 and 28 February 2021, who had a positive COVID-19 test and/or a COVID-19-related ICD-10 code.Main outcome measuresThe sensitivity, positive predictive value (PPV) and 95% CIs for ICD-10 codes were computed. Stratified analysis on age group, sex, symptomatic status, mechanical ventilation, hospital type, patient intensive care unit (ICU) admission, discharge status and season of pandemic were conducted.ResultsTwo overlapping subsets of the study population were considered: those who had a positive COVID-19 test (cohort A, for estimating sensitivity) and those who had a COVID-19-related ICD-10 code (cohort B, for estimating PPV). Cohort A included 17 979 ED patients and 6477 inpatients while cohort B included 33 675 ED patients and 18 746 inpatients. Of inpatients, 9.5% in cohort A and 8.1% in cohort B received mechanical ventilation. Over 13% of inpatients were admitted to ICU. The length of hospital stay was 6 days (IQR: 3–14) for cohort A and 8 days (IQR: 3–19) for cohort B. In-hospital mortality was 15.9% and 38.8% for cohort A and B, respectively. The sensitivity for ICD-10 code U07.1 (COVID-19, virus identified) was 82.5% (81.8%–83.2%) with a PPV of 93.1% (92.6%–93.6%). The combination of U07.1 and U07.3 (multisystem inflammatory syndrome associated with COVID-19) had a sensitivity of 82.5% (81.9%–83.2%) and PPV of 92.9% (92.4%–93.4%).ConclusionsIn Alberta, ICD-10 COVID-19 codes (U07.1 and U07.3) were coded well with high validity. This indicates administrative data can be used for COVID-19 research and pandemic management purposes.