Citation

Stewart CC, Simon G, Ahmedani BK, Beck A, Daida YG, Lynch FL, Owen-Smith AA, Negriff SL, Rossom R, Sterling SA, Lu CY, Schoenbaum M. Inj. Prev. 2024; ePub(ePub): ePub.

Copyright

(Copyright © 2024, BMJ Publishing Group)

DOI

10.1136/ip-2023-045164

PMID

38906684

Abstract

INTRODUCTION: Information about causes of injury is key for injury prevention efforts. Historically, cause-of-injury coding in clinical practice has been incomplete due to the need for extra diagnosis codes in the International Classification of Diseases-Ninth Revision-Clinical Modification (ICD-9-CM) coding. The transition to ICD-10-CM and increased use of clinical support software for diagnosis coding is expected to improve completeness of cause-of-injury coding. This paper assesses the recording of external cause-of-injury codes specifically for those diagnoses where an additional code is still required.

METHODS: We used electronic health record and claims data from 10 health systems from October 2015 to December 2021 to identify all inpatient and emergency encounters with a primary diagnosis of injury. The proportion of encounters that also included a valid external cause-of-injury code is presented.

RESULTS: Most health systems had high rates of cause-of-injury coding: over 85% in emergency departments and over 75% in inpatient encounters with primary injury diagnoses. However, several sites had lower rates in both settings. State mandates were associated with consistently high external cause recording.

CONCLUSIONS: Completeness of cause-of-injury coding improved since the adoption of ICD-10-CM coding and increased slightly over the study period at most sites. However, significant variation remained, and completeness of cause-of-injury coding in any diagnosis data used for injury prevention planning should be empirically determined.

Language: en

Keywords

Epidemiology; Coding Systems; Suicide/Self-Harm