NYU Langone Health, Department of Orthopedic Surgery, New York, New York.
J Arthroplasty. 2023 May;38(5):794-797. doi: 10.1016/j.arth.2022.12.002. Epub 2022 Dec 7.
The International Classification of Diseases-10 Procedure Code System (ICD-10-PCS) introduced oxidized zirconium (OxZi) and niobium procedural codes to the types of femoral head bearing surfaces in 2017. These codes aimed to increase procedural specificity in coding and improve data collection through administrative claims databases. This study aimed to assess the accuracy of ICD-10-PCS coding for femoral head bearing surfaces (cobalt chrome/metal, ceramic, and OxZi) in hip procedures.
A retrospective analysis of 6,204 procedures utilizing femoral heads performed between October 1, 2017 and August 26, 2021 at a large, urban academic hospital was conducted. Operative reports and implant logs were queried to determine the femoral head bearing surface, which was used during the total hip arthroplasty. These results were then compared to the ICD-10-PCS codes in the billing records. Coding accuracy was subsequently determined and statistical differences between the three groups were evaluated.
The ICD-10-PCS coding was accurate for 90.8% (5,634/6,204) of cases. Coding accuracy for ceramic femoral heads (95.4%, 4,171/4,371) was significantly greater than that of both cobalt chrome/metal (73.7%, 606/822; P < .001) and OxZi (84.8%, 857/1,011; P < .001) femoral heads.
While coding for ceramic femoral heads was very accurate, OxZi and cobalt chrome/metal femoral heads were miscoded at a rate of approximately 20%. These inaccuracies call for further evaluation of the ICD-10-PCS coding process to ensure that conclusions drawn from clinical research performed through administrative claims databases are not subject to error.
国际疾病分类第 10 次修订版操作代码系统（ICD-10-PCS）于 2017 年引入氧化锆（OxZi）和铌操作代码，用于股骨头的承载表面类型。这些代码旨在提高编码过程的专业性，并通过行政索赔数据库来改善数据收集。本研究旨在评估 ICD-10-PCS 编码对髋关节手术中股骨头承载表面（钴铬/金属、陶瓷和 OxZi）的准确性。
对 2017 年 10 月 1 日至 2021 年 8 月 26 日期间在一家大型城市学术医院进行的 6204 例股骨头手术进行回顾性分析。查询手术报告和植入物日志，以确定全髋关节置换术中使用的股骨头承载表面。然后将这些结果与计费记录中的 ICD-10-PCS 代码进行比较。随后确定编码准确性，并评估三组之间的统计学差异。
90.8%（5634/6204）的病例 ICD-10-PCS 编码准确。陶瓷股骨头的编码准确性（95.4%，4171/4371）明显高于钴铬/金属股骨头（73.7%，606/822；P<0.001）和 OxZi 股骨头（84.8%，857/1011；P<0.001）。
虽然陶瓷股骨头的编码非常准确，但 OxZi 和钴铬/金属股骨头的编码错误率约为 20%。这些不准确之处需要进一步评估 ICD-10-PCS 编码过程，以确保通过行政索赔数据库进行的临床研究得出的结论不受错误影响。
