Citation

Kaufman EJ, Wiebe DJ, Delgado MK. JAMA Intern. Med. 2021; ePub(ePub): ePub.

Copyright

(Copyright © 2021, American Medical Association)

DOI

10.1001/jamainternmed.2021.0385

PMID

unavailable

Abstract

In Reply We appreciate the concerns expressed by Barber et al about potential misclassification in medical billing coding of firearm injury intent in response to our article. Although many states and payers require external cause-of-injury coding, these codes are not routinely inspected for accuracy. This problem may have been exacerbated when the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) was introduced in 2015. Guidance for ICD-10 instructed coders to select unintentional injury when the intent of an injury is unclear, whereas previous guidance recommended codes for undetermined intent. Using data from our study, we calculated the proportion of nonfatal injuries classified as unintentional in the 2 years before and after the implementation of ICD-10. Unintentional injuries made up 80 566 of 176 155 (49.1%) of nonfatal injuries in 2013 and 2014, and 101 330 of 201 707 (54.8%) in 2016 and 2017, indicating that the policy change may account for a relatively small proportion of injuries that are coded as unintentional...

Language: en