Conversion of the Agency for Healthcare Research and Quality's Quality Indicators from ICD-9-CM to ICD-10-CM/PCS: The Process, Results, and Implications for Users.

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  • Additional Information
    • Source:
      Publisher: Blackwell Country of Publication: United States NLM ID: 0053006 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1475-6773 (Electronic) Linking ISSN: 00179124 NLM ISO Abbreviation: Health Serv Res Subsets: MEDLINE
    • Publication Information:
      Publication: Malden, MA : Blackwell
      Original Publication: Chicago, Hospital Research and Educational Trust.
    • Subject Terms:
      International Classification of Diseases* ; Quality Indicators, Health Care* ; United States Agency for Healthcare Research and Quality*; Clinical Coding ; Humans ; United States
    • Abstract:
      Objective: To convert the Agency for Healthcare Research and Quality's (AHRQ) Quality Indicators (QIs) from International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) specifications to ICD, 10th Revision, Clinical Modification and Procedure Classification System (ICD-10-CM/PCS) specifications.
      Data Sources: ICD-9-CM and ICD-10-CM/PCS classifications, General Equivalence Maps (GEMs).
      Study Design: We convened 77 clinicians and coders to evaluate ICD-10-CM/PCS codes mapped from ICD-9-CM using automated GEMs. We reviewed codes to develop "legacy" specifications resembling those in ICD-9-CM and "enhanced" specifications addressing enhanced capabilities of ICD-10-CM/PCS.
      Data Collection/extraction Methods: We tabulated the numbers of mapped codes, added nonmapped codes, and deleted mapped codes to achieve the specifications.
      Principal Findings: Of 212 clinical concepts (sets of codes) that comprise the QI specifications, we either added nonmapped codes to or deleted mapped codes from 115 (54 percent). The legacy and enhanced specifications differed for 46 sets (22 percent), affecting 67 of the 101 QIs (66 percent). Occasionally, concepts that defied conversion required reformulation of indicators.
      Conclusions: Converting the AHRQ QIs to ICD-10-CM/PCS required a detailed, thorough process beyond automated mapping of codes. Differences between the legacy and enhanced versions of the QIs are frequently minor but sometimes substantive.
      (© Health Research and Educational Trust.)
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    • Grant Information:
      HHSAA290201200003I International Agency for Healthcare Research and Quality; HHSA290201200001C International Agency for Healthcare Research and Quality
    • Contributed Indexing:
      Keywords: GEMs; ICD-10-CM/PCS; ICD-9-CM; Quality indicators; administrative data
    • Publication Date:
      Date Created: 20180531 Date Completed: 20190304 Latest Revision: 20220409
    • Publication Date:
      20240105
    • Accession Number:
      PMC6153152
    • Accession Number:
      10.1111/1475-6773.12981
    • Accession Number:
      29846001