Implementer report: ICD-10 code F44.5 review for functional seizure disorder.

IF 4.1 Q1 HEALTH CARE SCIENCES & SERVICES BMJ Health & Care Informatics Pub Date : 2023-09-01 DOI:10.1136/bmjhci-2023-100746
Sana F Ali, Yarden Bornovski, Margaret Gopaul, Daniela Galluzzo, Joseph Goulet, Stephanie Argraves, Ebony Jackson-Shaheed, Kei-Hoi Cheung, Cynthia A Brandt, Hamada Hamid Altalib
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Abstract

Objective: The study aimed to measure the validity of International Classification of Diseases, 10th Edition (ICD-10) code F44.5 for functional seizure disorder (FSD) in the Veterans Affairs Connecticut Healthcare System electronic health record (VA EHR).

Methods: The study used an informatics search tool, a natural language processing algorithm and a chart review to validate FSD coding.

Results: The positive predictive value (PPV) for code F44.5 was calculated to be 44%.

Discussion: ICD-10 introduced a specific code for FSD to improve coding validity. However, results revealed a meager (44%) PPV for code F44.5. Evaluation of the low diagnostic precision of FSD identified inconsistencies in the ICD-10 and VA EHR systems.

Conclusion: Information system improvements may increase the precision of diagnostic coding by clinicians. Specifically, the EHR problem list should include commonly used diagnostic codes and an appropriately curated ICD-10 term list for 'seizure disorder,' and a single ICD code for FSD should be classified under neurology and psychiatry.

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实施者报告:功能性癫痫发作障碍ICD-10代码F44.5审查。
目的:本研究旨在测量国际疾病分类第10版(ICD-10)代码F44.5在退伍军人事务康涅狄格州医疗保健系统电子健康记录(VA EHR)中对功能性癫痫(FSD)的有效性。方法:本研究使用信息学搜索工具、自然语言处理算法和图表评审来验证FSD编码。结果:编码F44.5的阳性预测值(PPV)为44%。讨论:ICD-10引入了一种用于FSD的特定编码,以提高编码的有效性。然而,结果显示代码F44.5的PPV很低(44%)。FSD诊断精度低的评估发现ICD-10和VA EHR系统不一致。结论:信息系统的改进可以提高临床医生诊断编码的准确性。具体而言,EHR问题列表应包括常用的诊断代码和适当策划的ICD-10“癫痫发作障碍”术语列表,FSD的单一ICD代码应归类为神经病学和精神病学。
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CiteScore
6.10
自引率
4.90%
发文量
40
审稿时长
18 weeks
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