ICD-10-CM转换对心理健康诊断记录的影响

Christine C Stewart, Christine Y Lu, Tae K Yoon, Karen J Coleman, Phillip M Crawford, Matthew D Lakoma, Gregory E Simon
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引用次数: 26

摘要

目的:本研究探讨了从ICD-9-CM到ICD-10-CM诊断编码的转换对10个大型卫生系统中电子健康档案(EHRs)中精神健康障碍记录和索赔数据的影响。我们展示了从2015年10月开始的两年内这些诊断的比率。方法:从心理健康研究网络(MHRN)的10个卫生保健系统的索赔和电子病历数据中确定心理健康诊断。编制相应的ICD-9-CM和ICD-10-CM编码,并计算编码转换前后一年内每月接受这些诊断的人数。结果:对于8个诊断类别中的7个,ICD-10-CM转换前后一年的月发病率具有可比性。在其余类别中,精神病(不包括精神分裂症谱系障碍),随着ICD-10-CM的转换,每月总发病率显著下降,从每10万人48例降至33例。我们认为这种变化是由于EHR中嵌入了通用等价映射(GEMS)的特征。结论:对于大多数精神健康状况,过渡到ICD-10-CM似乎影响最小。在这些卫生系统中,精神病诊断的减少可能是由于电子病历实施ICD-10-CM编码相关的变化,而不是疾病患病率的实际变化。重要的是要考虑ICD-10-CM在这段时间内对研究、质量测量和财务分析中使用的所有诊断标准的影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Impact of ICD-10-CM Transition on Mental Health Diagnoses Recording.

Impact of ICD-10-CM Transition on Mental Health Diagnoses Recording.

Impact of ICD-10-CM Transition on Mental Health Diagnoses Recording.

Impact of ICD-10-CM Transition on Mental Health Diagnoses Recording.

Objective: This study examines the impact of the transition from ICD-9-CM to ICD-10-CM diagnosis coding on the recording of mental health disorders in electronic health records (EHRs) and claims data in ten large health systems. We present rates of these diagnoses across two years spanning the October 2015 transition.

Methods: Mental health diagnoses were identified from claims and EHR data at ten health care systems in the Mental Health Research Network (MHRN). Corresponding ICD-9-CM and ICD-10-CM codes were compiled and monthly rates of people receiving these diagnoses were calculated for one year before and after the coding transition.

Results: For seven of eight diagnostic categories, monthly rates were comparable during the year before and the year after the ICD-10-CM transition. In the remaining category, psychosis excluding schizophrenia spectrum disorders, aggregate monthly rates of decreased markedly with the ICD-10-CM transition, from 48 to 33 per 100,000. We propose that the change is due to features of General Equivalence Mappings (GEMS) embedded in the EHR.

Conclusions: For most mental health conditions, the transition to ICD-10-CM appears to have had minimal impact. The decrease seen for psychosis diagnoses in these health systems is likely due to changes associated with EHR implementation of ICD-10-CM coding rather than an actual change in disease prevalence. It is important to consider the impact of the ICD-10-CM transition for all diagnostic criteria used in research studies, quality measurement, and financial analysis during this interval.

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