Mina A Allo
Background: Transition from ICD version 9 to 10 was mandated for US hospitals on Oct 1, 2015. ICD codes for thrombolysis in ischemic stroke (IS) are often used for research and quality assurance. Methods: The 2015-2016 period of the National Inpatient Sample, a weighted 20% sample of all inpatient US hospital discharges, was examined. During the ICD 9 period, discharges of interest were identified using codes for IS combined with the procedural code associated with thrombolysis (Table 1). Two strategies were used in the ICD 10 period: 1) ICD 9 procedural code (99.10) was mapped to only the ICD 10 code for thrombolytic given into a peripheral vein and 2) to all related new ICD 10 codes including injection of thrombolytic agent into an artery, a central vein, or the heart. In both strategies, these codes were combined with ICD 10 codes for IS (Table 1). Results: Within the 3rd quarter of 2015, there were 2,208 sampled discharges who received thrombolysis for IS representing a total of 11,040 patients. Within the last quarter of 2015 there were 1,862 sampled discharges representing 9,310 patients using strategy 1 and 2,128 sampled discharges representing 10,640 patients using strategy 2 (Table 2, Figure 1). Conclusion: Significant discontinuity was seen during the ICD 9 to ICD 10 transition period which necessitates the need for more rigorous validation of these codes prior to use for identify patients undergoing thrombolysis for IS in administrative data.
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