实施者报告：功能性癫痫障碍 ICD-10 代码 F44.5 审核。
Implementer report: ICD-10 code F44.5 review for functional seizure disorder.
机构信息
Neurology, Yale School of Medicine, New Haven, Connecticut, USA.
Neurology, VA Connecticut Healthcare System West Haven VA Medical Center, West Haven, Connecticut, USA.
出版信息
BMJ Health Care Inform. 2023 Sep;30(1). doi: 10.1136/bmjhci-2023-100746.
OBJECTIVE
The study aimed to measure the validity of International Classification of Diseases, 10th Edition (ICD-10) code F44.5 for functional seizure disorder (FSD) in the Veterans Affairs Connecticut Healthcare System electronic health record (VA EHR).
METHODS
The study used an informatics search tool, a natural language processing algorithm and a chart review to validate FSD coding.
RESULTS
The positive predictive value (PPV) for code F44.5 was calculated to be 44%.
DISCUSSION
ICD-10 introduced a specific code for FSD to improve coding validity. However, results revealed a meager (44%) PPV for code F44.5. Evaluation of the low diagnostic precision of FSD identified inconsistencies in the ICD-10 and VA EHR systems.
CONCLUSION
Information system improvements may increase the precision of diagnostic coding by clinicians. Specifically, the EHR problem list should include commonly used diagnostic codes and an appropriately curated ICD-10 term list for 'seizure disorder,' and a single ICD code for FSD should be classified under neurology and psychiatry.
目的
本研究旨在衡量退伍军人事务康涅狄格医疗保健系统电子健康记录（VA EHR）中国际疾病分类第 10 版（ICD-10）F44.5 代码用于功能性癫痫障碍（FSD）的有效性。
方法
本研究使用了一种信息学搜索工具、一种自然语言处理算法和图表审查来验证 FSD 编码。
结果
F44.5 代码的阳性预测值（PPV）计算为 44%。
讨论
ICD-10 引入了一个特定的 FSD 代码，以提高编码的有效性。然而，结果显示 F44.5 代码的 PPV 很低（44%）。对 FSD 诊断精度低的评估发现 ICD-10 和 VA EHR 系统存在不一致之处。
结论
信息系统的改进可以提高临床医生诊断编码的准确性。具体来说，电子健康记录的问题清单应包括常用的诊断代码和经过适当策划的 ICD-10 术语列表，用于“癫痫障碍”，而 FSD 的单一 ICD 代码应归类于神经病学和精神病学。
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