S A Iqbal1, C J Isenhour2, G Mazurek3, B I Truman1. 1. Office of the Associate Director for Science, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP), Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA. 2. Division of Health Informatics and Surveillance, Center for Surveillance, Epidemiology and Laboratory Services, CDC, Atlanta, GA. 3. Division of Tuberculosis Elimination, NCHHSTP, CDC, Atlanta, GA, USA.
Abstract
OBJECTIVE: To measure the frequency of diseases related to latent tuberculosis infection (LTBI) and tuberculosis (TB), we assessed the agreement between diagnosis codes for TB or LTBI in electronic health records (EHRs) and insurance claims for the same person. METHODS: In a US population-based, retrospective cohort study, we matched TB-related Systematized Nomenclature of Medicine-Clinical Terms (SNOMED CT) EHR codes and International Statistical Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) claims codes. Furthermore, LTBI was identified using a published ICD-based algorithm and all LTBI- and TB-related SNOMED CT codes. RESULTS: Of people with the 10 most frequent TB-related claim codes, 50% did not have an exact-matched EHR code. Positive tuberculin skin test was the most frequent unmatched EHR code and people with the 10 most frequent TB EHR codes, 40% did not have an exact-matched claim code. The most frequent unmatched claim code was TB screening encounter. EHR codes for LTBI matched to claims codes for TB testing; pulmonary TB; and nonspecific, positive or adverse tuberculin reaction. CONCLUSION: TB-related EHR codes and claims diagnostic codes often disagree, and people with claims codes for LTBI have unexpected EHR codes, indicating the need to reconcile these coding systems.
OBJECTIVE: To measure the frequency of diseases related to latent tuberculosis infection (LTBI) and tuberculosis (TB), we assessed the agreement between diagnosis codes for TB or LTBI in electronic health records (EHRs) and insurance claims for the same person. METHODS: In a US population-based, retrospective cohort study, we matched TB-related Systematized Nomenclature of Medicine-Clinical Terms (SNOMED CT) EHR codes and International Statistical Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) claims codes. Furthermore, LTBI was identified using a published ICD-based algorithm and all LTBI- and TB-related SNOMED CT codes. RESULTS: Of people with the 10 most frequent TB-related claim codes, 50% did not have an exact-matched EHR code. Positive tuberculin skin test was the most frequent unmatched EHR code and people with the 10 most frequent TB EHR codes, 40% did not have an exact-matched claim code. The most frequent unmatched claim code was TB screening encounter. EHR codes for LTBI matched to claims codes for TB testing; pulmonary TB; and nonspecific, positive or adverse tuberculin reaction. CONCLUSION: TB-related EHR codes and claims diagnostic codes often disagree, and people with claims codes for LTBI have unexpected EHR codes, indicating the need to reconcile these coding systems.
Authors: Diane E Bennett; Jeanne M Courval; Ida Onorato; Tracy Agerton; Judy D Gibson; Lauren Lambert; Geraldine M McQuillan; Brenda Lewis; Thomas R Navin; Kenneth G Castro Journal: Am J Respir Crit Care Med Date: 2007-11-07 Impact factor: 21.405
Authors: Roque Miramontes; Andrew N Hill; Rachel S Yelk Woodruff; Lauren A Lambert; Thomas R Navin; Kenneth G Castro; Philip A LoBue Journal: PLoS One Date: 2015-11-04 Impact factor: 3.240