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Development and Testing of Compatible Diagnosis Code Lists for the Functional Comorbidity Index: International Classification of Diseases, Ninth Revision, Clinical Modification and International Classification of Diseases, 10th Revision, Clinical Modification
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12 2020
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Source: Med Care. 58(12):1044-1050
Details:
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Alternative Title:Med Care
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Personal Author:
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Description:Background
The Functional Comorbidity Index (FCI) was developed for community-based adult populations, with function as the outcome. The original FCI was a survey tool, but several International Classification of Diseases (ICD) code lists—for calculating the FCI using administrative data—have been published. However, compatible ICD-9-CM and ICD-10-CM versions have not been available.
Objectives
We developed ICD-9-CM and ICD-10-CM diagnosis code lists to optimize FCI concordance across ICD lexicons.
Research Design
We assessed concordance and frequency distributions across ICD lexicons for the FCI and individual comorbidities. We used length of stay and discharge disposition to assess continuity of FCI criterion validity across lexicons.
Subjects
State Inpatient Databases (SID) from Arizona, Colorado, Michigan, New Jersey, New York, Utah, and Washington State (calendar year 2015) were obtained from the Healthcare Cost and Utilization Project. SID contained ICD-9-CM diagnoses for the first 3 calendar quarters of 2015, and ICD-10-CM diagnoses for the fourth quarter of 2015. Inpatients under 18 years old were excluded.
Measures
Length of stay and discharge disposition outcomes were assessed in separate regression models. Covariates included age, gender, state, ICD lexicon, and FCI/lexicon interaction.
Results
The FCI demonstrated stability across lexicons, despite small discrepancies in prevalence for individual comorbidities. Under ICD-9-CM, each additional comorbidity was associated with an 8.9% increase in length of stay and an 18.5% decrease in the odds of a routine discharge, compared to an 8.4% increase and 17.4% decrease, respectively, under ICD-10-CM.
Conclusions
This study provides compatible ICD-9-CM and ICD-10-CM diagnosis code lists for the FCI.
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Pubmed ID:33003052
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Pubmed Central ID:PMC7717170
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