Database research that relies on ICD-10 coding as a surrogate for primary clinical data should be interpreted with caution and institutions should make efforts to increase the accuracy of their coding.Īccuracy Ankle fracture ICD-10 coding Positive predictive value.Ĭopyright © 2021 Elsevier Ltd. There is substantial discordance between existing EMR and surgeon-assigned ICD-10 codes for ankle fractures. S82.61XD Displaced fracture of lateral malleolus of right fibula, subsequent encounter for closed fracture with routine healing. EMR codes were specific but not sensitive. Generalized "other fracture" codes comprised 45% of EMR codes compared to only 6% of assigned codes (p < 0.001). Lateral malleolus fracture codes demonstrated the highest PPV (0.91, 95% CI 0.72-0.99), while the lowest PPV was found for "other fractures of the lower leg" (0.05, 95% CI 0.0-0.24) and "other fracture of the fibula" (0.0, 95% CI 0.0-0.15). Aggregate agreement between all codes was fair (K = 0.26). Agreement between the correct code and the electronic medical record (EMR) assigned code was determined using kappa's statistic in the aggregate as well as percent agreement, sensitivity, specificity, and positive predictive value (PPV) between individual codes.ĥ9 of 97 cases (60.8%) demonstrated discordance between the existing EMR and surgeon-assigned codes. S82.61XA is a valid billable ICD-10 diagnosis code for Displaced fracture of lateral malleolus of right fibula, initial encounter for closed fracture.It is found in the 2023 version of the ICD-10 Clinical Modification (CM) and can be used in all HIPAA-covered transactions from Sep 30, 2023. Injury radiographs were reviewed by three authors to determine the correct code. Retrospective cohort study PATIENTS: 97 adult patients with fractures about the ankle (rotational ankle fracture or distal tibia fracture) from 2016 to 2020, selected by stratified random sampling.Īssignment of an ICD-10 code representative of a rotational ankle fracture, pilon fracture, or unspecified fracture of the lower leg. To determine the accuracy of International Classification of Disease Version 10 (ICD-10) coding for ankle fracture injury patterns.
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