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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
Author(s) -
Utter Garth H.,
Cox Ginger L.,
Atolagbe Oluseun O.,
Owens Pamela L.,
Romano Patrick S.
Publication year - 2018
Publication title -
health services research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.706
H-Index - 121
eISSN - 1475-6773
pISSN - 0017-9124
DOI - 10.1111/1475-6773.12981
Subject(s) - quality (philosophy) , computer science , equivalence (formal languages) , agency (philosophy) , quality management , database , medicine , data mining , operations management , engineering , mathematics , management system , philosophy , epistemology , discrete mathematics
Objective To convert the Agency for Healthcare Research and Quality's ( AHRQ ) Quality Indicators ( QI s) 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 GEM s. 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 QI s (66 percent). Occasionally, concepts that defied conversion required reformulation of indicators. Conclusions Converting the AHRQ QI s to ICD ‐10‐ CM / PCS required a detailed, thorough process beyond automated mapping of codes. Differences between the legacy and enhanced versions of the QI s are frequently minor but sometimes substantive.