Revalidation of the hypoglycemia risk stratification tool using ICD-10 codes
Open accessAbstract
We previously developed and validated a hypoglycemia risk stratification tool (1) and made available the computer source code for implementation (online-only supplemental eTable 2 [1]). This tool classifies 12-month risk of hypoglycemia-related utilization (HRU) of emergency department (ED) or in-patient services among type 2 diabetes (T2D) patients as high (>5%), intermediate (1–5%), or low (<1%). Since its publication, health care delivery systems in the U.S. (including Kaiser Permanente and Mayo Clinic) have adopted this tool to identify higher-risk patients for targeted population management interventions designed to reduce hypoglycemia risk. Among the six inputs required to calculate HRU risk (prior HRU, insulin use, sulfonylurea use, any ED visits, chronic kidney disease stage, and age), only prior HRU relied on diagnostic coding and was based on an algorithm (2) comprising International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes. Since 1 October 2015, the Centers for Medicare & Medicaid Services has required use of the 10th revision (ICD-10-CM), necessitating an updated HRU case identification algorithm that includes ICD-10-CM codes for hypoglycemia. We identified ICD-10-CM codes for hypoglycemia to complement the existing ICD-9-CM–based algorithm (any of the following: 251.0, 251.1, 251.2, 962.3, or 250.8, without concurrent 259.8, 272.7, 681.XX, 682.XX, 686.9X, 707.1–707.9, 709.3, 730.0–730.2, or 731.8). The ICD-10-CM codes for hypoglycemia (any of the …
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Validated tools have been developed to estimate hypoglycemia risk using predominantly electronic health record data.
“Validated tools have been developed to estimate hypoglycemia risk using predominantly electronic health record data (101-103).”
From 6. Glycemic Goals, Hypoglycemia, and Hyperglycemic Crises: Standards of Care in Diabetes-2026. (2026) · cites this paper as [102]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
The citation lists haven’t been fetched yet
References 3 · Cited by 42
- Authors
- Karter, A. J., Warton, E. M., Moffet, H. H., Ralston, J. D., Huang, E. S., Miller, D. R., & Lipska, K. J.
- Affiliations
- Kaiser Permanente (US)
- Kaiser Permanente Washington Health Research Institute (US)
- University of Chicago (US)
- Edith Nourse Rogers Memorial Veterans Hospital (US)
- Yale University (US)
- Corresponding author
- Karter, Andrew J.
- ORCID
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2019-02-14
- Volume
- 42
- Issue
- 4
- Pages
- e58-e59
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- PMC
- PMC6429629
- OpenAlex
- W2913451141
- Cited by
- 42
- References
- 3
- Citations by year
- 2026: 7 · 2025: 12 · 2024: 7 · 2023: 7 · 2022: 2 · 2021: 5 · 2019: 2
- FWCI
- 1.83
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Diabetes Care (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Food and Drug Administration (FDA BAA-13 00119)
- National Institute of Diabetes and Digestive and Kidney Diseases (R01 DK103721, P30 DK092924, P30 DK092949)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Health Professions › Health Information Management › Medical Coding and Health Information
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Keywords
- type 2 diabetes, ICD-10-CM codes, ICD-9-CM codes, emergency department visits, inpatient utilization, insulin use, chronic kidney disease, population management
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
