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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