An 8-step algorithm translating ICD-9 to ICD-10 codes for complications after carotid revascularization and endovascular aortic aneurysm repair achieved 98% concordance upon manual physician review.
An 8-step algorithm using publicly available crosswalks successfully translated ICD-9 to ICD-10 codes for vascular complications with 98% concordance, though manual review remains necessary.
Background On October 1, 2015, the Center for Medicare and Medicaid Services transitioned from the International Classification of Diseases, Ninth Revision ( ICD-9) to the ICD, Tenth Revision ( ICD-10) compendium of codes for diagnosis and billing in health care, but translation between the two is often inexact. Here we describe a validated crosswalk to translate ICD-9 codes into ICD-10 codes, with a focus on complications after carotid revascularization and endovascular aortic aneurysm repair. Methods and Results We devised an 8-step process to derive and validate ICD-10 codes from existing ICD-9 codes. We used publicly available sources, including the General Equivalence Mapping database, to translate ICD-9 codes used in prior work to ICD-10 codes. We defined ICD-10 codes as validated if they were concordant with the initial ICD-9 codes after manual comparison by two physicians. Our primary validation measure was the percent of valid ICD-10 codes out of the total ICD-10 codes obtained during translation. We began with 126 ICD-9 diagnosis codes used for complication identification after carotid revascularization procedures, and 97 ICD-9 codes for complications after endovascular aortic aneurysm procedures. Translation generated 143 ICD-10 codes for carotid revascularization, a 14% increase from the initial 126 codes. Manual comparison demonstrated 98% concordance, with 99% agreement between the reviewers. Similarly, we identified 108 ICD-10 codes for endovascular aortic aneurysm repair, an 11% increase from the initial 97 ICD-9 codes. We again noted excellent concordance and agreement (98% and 100%, respectively). Manual review identified 4 ICD-10 codes incorrectly translated from ICD-9 codes for carotid revascularization, and 3 codes incorrectly translated for endovascular aortic aneurysm repair. Conclusions Algorithms to crosswalk lists of ICD-9 codes to ICD-10 codes can leverage electronic resources to minimize the burden of code translation. However, manual review for code validation may be necessary, with collaboration across institutions for researchers to share their efforts.
Columbo et al. (2018) studied Complications after carotid revascularization and endovascular aortic aneurysm repair. Algorithm to crosswalk ICD-9 to ICD-10 codes vs. Manual physician review was evaluated on Percent of valid ICD-10 codes out of the total ICD-10 codes obtained during translation (concordance with initial ICD-9 codes). An 8-step algorithm translating ICD-9 to ICD-10 codes for complications after carotid revascularization and endovascular aortic aneurysm repair achieved 98% concordance upon manual physician review.