Study of Acute Esophageal Variceal Bleeding in Liver Cirrhosis Patients
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CitationBi, Qian. 2020. Study of Acute Esophageal Variceal Bleeding in Liver Cirrhosis Patients. Master's thesis, Harvard Medical School.
AbstractBackground & Aims: Claims databases are used ever more widely in medical research. The building blocks of such databases are the ICD-10 CM codes, which are used to identify study patients, exposures and procedures. We aimed to determine the performance characteristics of the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10 CM) and the current procedural terminology (CPT) coding systems in identifying patients with acute esophageal variceal hemorrhage and esophageal variceal band ligation. Methods: Both liver cirrhosis and acute gastrointestinal hemorrhage were ascertained using manual electronical medical record review. The study patients’ billing records were obtained and searched for ICD-10 CM code I85.xx for esophageal variceal hemorrhage and 06L34CZ, 06L38CZ and CPT code 43244 for esophageal variceal band ligation. Results:1,231 patient encounters were included. Alcohol was the most common etiology for liver cirrhosis (62.3%), and hematemesis (40.5%) was the most common patient presentation. A principal diagnosis ICD-10 CM code of I85.xx was associated with high sensitivity (84.8%), specificity (88.6%), positive (PPV, 92.9%) and negative (NPV, 77.0%) predictive values for presence of esophageal varices. For esophageal variceal band ligation, the ICD-10 CM had lower sensitivity than the CPT codes (51% versus 77%, respectively). However, both systems had similar specificity (99% and 99%), positive (97% and 96%), and negative (86% and 93%) predictive values in this setting. Conclusions: ICD-10 CM diagnostic code I85.xx and procedure codes 06L34CZ and 06L38CZ as well as CPT code 43244 accurately identified patients with acute esophageal variceal hemorrhage and esophageal variceal band ligation, respectively.
Citable link to this pagehttps://nrs.harvard.edu/URN-3:HUL.INSTREPOS:37365243