Clinical Epidemiology (Oct 2021)

Positive Predictive Value of COVID-19 ICD-10 Diagnosis Codes Across Calendar Time and Clinical Setting

  • Lynch KE,
  • Viernes B,
  • Gatsby E,
  • DuVall SL,
  • Jones BE,
  • Box TL,
  • Kreisler C,
  • Jones M

Journal volume & issue
Vol. Volume 13
pp. 1011 – 1018

Abstract

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Kristine E Lynch,1,2 Benjamin Viernes,1,2 Elise Gatsby,1 Scott L DuVall,1,2 Barbara E Jones,2,3 Tamára L Box,4 Craig Kreisler,4 Makoto Jones2,3 1VA Informatics and Computing Infrastructure (VINCI), VA Salt Lake City Health Care System, Salt Lake City, UT, USA; 2Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA; 3Informatics, Decision-Enhancement, and Analytic Sciences (IDEAS) Center of Innovation, VA Salt Lake City Health Care System, Salt Lake City, UT, USA; 4Analytics and Performance Integration (API), Office of Quality and Patient Safety, Veterans Health Administration, Washington, DC, USACorrespondence: Kristine E LynchVA Informatics and Computing Infrastructure (VINCI), VA Salt Lake City Health Care System, 500 Foothill Drive, Salt Lake City, UT, 84148, USATel +1 801 582 1565 ext. 1913Email [email protected]: To estimate the positive predictive value (PPV) of International Classification of Diseases, Tenth Revision (ICD-10) code U07.1, COVID-19 virus identified, in the Department of Veterans of Affairs (VA).Patients and Methods: Records of ICD-10 code U07.1 from inpatient, outpatient, and emergency/urgent care settings were extracted from VA medical record data from 4/01/2020 to 3/31/2021. A weighted, random sample of 1500 records from each quarter of the one-year observation period was reviewed by study personnel to confirm active COVID-19 infection at the time of diagnosis and classify reasons for false positive records. PPV was estimated overall and compared across clinical setting and quarters.Results: We identified 664,406 records of U07.1. Among the 1500 reviewed, 237 were false positives (PPV: 84.2%, 95% CI: 82.4– 86.0). PPV ranged from 77.7% in outpatient settings to 93.8% in inpatient settings and was 83.3% in quarter 1, 80.5% in quarter 2, 86.1% in quarter 3, and 83.6% in quarter 4. The most common reasons for false positive records were history of COVID-19 (44.3%) and orders for laboratory tests (21.5%).Conclusion: The PPV of ICD-10 code U07.1 is low, especially in outpatient settings. Directed training may improve accuracy of coding to levels that are deemed adequate for future use in surveillance efforts.Keywords: SARS CoV-2, validation, administrative codes, electronic health records

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