Dive Brief:
- A new study published in the Journal of the American Medical Informatics Association has concluded that the transition to ICD-10 coding has a negative effect on patient safety reporting because of problems in comparing the new codes with the old.
- For the study, researchers at the University of Illinois at Chicago looked at 23 different types of patient safety indicators, then compared the accuracy of these patient safety indicators when used in ICD-9 and ICD-10 code sets.
- The researchers concluded that of 23 PSIs examined, three PSIs under ICD-9 had straightforward equivalents in ICD-10, but 15 PSIs under ICD-9 resulted in convoluted mapping to ICD-10, and that five PSIs used under ICD-9 had no equivalents whatsoever in ICD-10.
Dive Insight:
This study suggests that the transition to ICD-10 might create the safety measurement problems that some industry participants have been anticipating. Specifically, it could inadvertently increase the number of PSIs in use, making it impossible to compare the two when ICD-10 rolls out.
This is important because this issue could raise the risks of underreported safety incidents or lead to unneeded inflation of PSIs because of ICD-10's more detailed codes. This problem could also offer providers incentives to perform translations that appeared to improve adverse event statistics, even while actual events may be unchanged or even worsened.
To avoid these concerns, the study's authors suggested that coding guidelines are needed to help providers use ICD-10. They also recommend that CMS publicly list improved and deleted PSIs to help keep the public and providers informed about the changes.