Quantifying Plastic and Reconstructive Surgery Engagement in the Evolution of ICD-10 Codes.

Abstract

Background: International Classification of Diseases (ICD)-10 code specificity is important for detailed diagnostic documentation. Insufficient coding granularity in plastic surgery may hinder accurate clinical documentation, impacting education, research, and patient care. This study examines ICD-10 code modification efforts by plastic surgeons and plastic surgery organizations within the last decade, subsequently detailing the formal proposal process and highlighting potential areas where coding modifications may be explored.

Methods: A retrospective review of all modification proposals presented to the ICD Coordination and Maintenance Committee from March 2013 to March 2023 was conducted. Plastic surgery-related proposals were identified and evaluated for successful implementation. These results were compared to those of other specialties using Fisher exact tests and 2-tailed t tests.

Results: A total of 472 unique proposals were identified and reviewed. Surgeons and/or surgical organizations contributed to 111 (23.5%) novel proposals, 41 (36.9%) of which were initiated by surgeons. Nine surgical specialties and 14 supporting organizations were represented. The success rate for all surgical-related proposals was 85.6%, with an average time to implementation of 24.7 months. Only 2 (1.8%) of all surgical-related proposals pertained to plastic surgery, both of which were successfully implemented.

Conclusions: Though a few plastic surgeons have taken advantage of the ICD code revision process within the last decade, the high overall success rate for surgical-related proposals suggests that this seems to be a feasible method by which plastic surgeons and plastic surgery organizations can bring about useful coding changes that meaningfully impact clinical practice.