Impact of ICD-9-CM to ICD-10-CM coding transition on trauma hospitalization trends among young adults in 12 states
Open accessAbstract
Background: We aimed to estimate the impact of the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) coding transition on traumatic injury-related hospitalization trends among young adults across a geographically and demographically diverse group of U.S. states. Methods: Interrupted time series analyses were conducted using statewide inpatient databases from 12 states and including traumatic injury-related hospitalizations in adults aged 19–44 years in 2011–2017. Segmented regression models were used to estimate the impact of the October 2015 coding transition on external cause of injury (ECOI) completeness (percentage of hospitalizations with a documented ECOI code) and on population-level rates of injury-related hospitalizations by nature, intent, mechanism, and severity of injury. Results: The transition to ICD-10-CM was associated with a drop in ECOI completion in the transition month (− 3.7%; P < .0001), but there was no significant change in the positive trend in ECOI completion from the pre- to post-transition periods. There were significant increases post-transition in the measured rates of hospitalization for traumatic brain injury (TBI), unintentional injury, mild injury (injury severity score (ISS) < 9), and injuries caused by drowning, firearms, machinery, other pedestrian, suffocation, and unspecified mechanism. Conversely, there were significant decreases in October 2015 in the rates of hospitalization for assault, injuries of undetermined intent, injuries of moderate severity (ISS 9–15), and injuries caused by fire/burn, other pedal cyclist, other transportation, natural/environmental, and other specified mechanism. A significant increase in the percentage of hospitalizations classified as resulting from severe injury (ISS > 15) was observed when the general equivalence mapping maximum severity method for converting ICD-10-CM codes to ICD-9-CM codes was used. State-specific results for the outcomes of ECOI completion and TBI-related hospitalization rates are provided in an online supplement. Conclusions: The U.S. transition from ICD-9-CM to ICD-10-CM coding led to a significant decrease in ECOI completion and several significant changes in measured rates of injury-related hospitalizations by injury intent, mechanism, nature, and severity. The results of this study can inform the design and analysis of future traumatic injury-related health services research studies that use both ICD-9-CM and ICD-10-CM coded data. Level of evidence: II (Interrupted Time Series)
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Indications for diagnoses based on medical data may have changed since a dataset was created and labelled, and changes in coding systems may affect mortality and injury statistics.
“Indications for diagnoses based on medical data may have changed since a dataset was created and labelled, and changes in coding systems (such as the transition from ICD-9 to ICD-10 or ICD-9-CM to ICD-10-CM) may affect mortality and injury statistics218,219.”
From The METRIC-framework for assessing data quality for trustworthy AI in medicine: A systematic review (2024) · cites this paper as [219]
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The METRIC-framework for assessing data quality for trustworthy AI in medicine: A systematic review
Schwabe, D., Becker, K., Seyferth, M., Klaß, A., & Schaeffter, T. (2024) · npj Digital Medicine · doi:10.1038/s41746-024-01196-4 · Cited by 169 · see citing works
- Authors
- Sebastião, Y. V., Metzger, G. A., Chisolm, D. J., Xiang, H., & Cooper, J. N.
- Affiliations
- University of North Carolina at Chapel Hill (US)
- Abigail Wexner Research Institute (US)
- Nationwide Children's Hospital (US)
- Corresponding author
- Cooper, Jennifer N.
- Venue
- Injury Epidemiology
- Published
- 2021-01-25
- Volume
- 8
- Issue
- 1
- Pages
- 4-4
- ISSN
- 2197-1714 (ISSN-L)
- PMC
- PMC7830822
- OpenAlex
- W3122050495
- Cited by
- 28
- References
- 1
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 6 · 2023: 2 · 2022: 12 · 2021: 2
- FWCI
- 4.79
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Injury Epidemiology (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, other-oa)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- National Center on Minority Health and Health Disparities (R01MD013881)
- Topics
- Health Sciences › Health Professions › Health Information Management › Medical Coding and Health Information
- Health Sciences › Medicine › Emergency Medicine › Trauma and Emergency Care Studies
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Injury Epidemiology and Prevention
- Keywords
- ICD-9-CM, trauma hospitalization, young adults, external causes of injury, Injury Severity Score, traumatic brain injury, injury mechanisms, injury intent, injury classification, health data quality, injury surveillance
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