Journal of Trauma and Injury

The Korean Society of Traumatology (대한외상학회)
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The Accuracy of the ICD-10 Code for Trauma Patients Visiting on Emergency Department and the Error in the ICISS

응급센터에 내원한 외상 환자에 있어 ICD-10 (International Classification of Disease-10)입력의 정확성과 ICISS (International Classification of Disease Based Injury Severity Score)점수의 오류

  • Lee, Jae Hyuk (Department of Emergency Medicine, Samsung Medical Center Sungkyunkwan University School of Medicine) ;
  • Sim, Min Seob (Department of Emergency Medicine, Samsung Medical Center Sungkyunkwan University School of Medicine)
  • 이재혁 (성균관의대 삼성서울병원 응급의학과) ;
  • 심민섭 (성균관의대 삼성서울병원 응급의학과)
  • Received : 2009.05.15
  • Accepted : 2009.06.10
  • Published : 2009.06.30
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Abstract

Purpose: We designed a retrospective study to measure the accuracy of the ICD-10 (International Classification of Disease-10) code for trauma patients. We also analyzed the error of the ICISS (International Classification of Disease based Injury Severity Score) due to a missing or an incorrect ICD-10 code. Methods: For the measuring the accuracy of the ICD-10 code for trauma patients in a tertiary teaching hospital's emergency department, two board certified emergency physician performed a retrospective chart review. The ICD-10 code was classified as a main code or a sub-code. The main code was defined as the code of the main department of treatment, and the sub-code was defined as a code other than the main code. We calculated and compared two ICISS for each patient one by using both the existing code and the other by using a corrected code. We compared the proportions of severe trauma (defined as an ICISS less than 0.9) between when the existing code and the corrected code was used respectively. Results: We reviewed the records of 4287 trauma patients who had been treated from July 2008 to November 2008. The accuracy of the main code, the sub-code of emergency department, main-code, the sub-code of hospitalized patients were 97.1%, 59.8%, 98.2% and 57.0%, respectively. Total accuracy of the main and sub-code of emergency department and of hospitalized patients were 91.4% and 58.6%. The number of severe trauma patients increased from 33 to 49 when the corrected code was used in emergency department and increased from 35 to 60 in hospitalized patients. Conclusion: The accuracy of the sub-code was lower than that of the main code. A missing or incorrect subcode could cause an error in the ICISS and in the number of patients with severe trauma.

Keywords

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