International classification of diseases and current procedural terminology codes underestimated thrombolytic use for ischemic stroke

J Clin Epidemiol. 2006 Aug;59(8):856-8. doi: 10.1016/j.jclinepi.2006.01.004. Epub 2006 May 23.


Background and objective: To determine the accuracy of recently introduced International Classification of Diseases Ninth Revision (ICD-9) procedure and Current Procedural Terminology (CPT) codes designed for injection or infusion of thrombolytic agents.

Materials and methods: We determined the accuracy of ICD-9 procedure code 99.10 and CPT codes 37201, 37202 for use of thrombolysis in ischemic stroke by comparing procedure codes of University Hospital discharge data with a concurrent prospective registry.

Results: Of the 369 ischemic stroke patients, 49 (13.3%) received either intravenous and/or intraarterial thrombolysis. The sensitivity and specificity for ICD-9 procedure code 99.10 was 55% and 98% and CPT procedure code 37201 and 37202 was 49% and 99%. Identification by either ICD-9 codes or CPT codes yielded a high sensitivity and specificity of 82% and 98%.

Conclusions: The use of ICD-9 and CPT codes alone may underestimate the use of thrombolytics using national and regional database. Best results are achieved when a combination of ICD-9 and CPT codes are used to identify the use of thrombolytics.

MeSH terms

  • Brain Ischemia / complications
  • Brain Ischemia / diagnosis*
  • Brain Ischemia / epidemiology
  • Current Procedural Terminology*
  • Fibrinolytic Agents / therapeutic use
  • Hospital Records
  • Hospitals, University
  • Humans
  • Incidence
  • International Classification of Diseases / standards*
  • Sensitivity and Specificity
  • Stroke / diagnosis*
  • Stroke / epidemiology


  • Fibrinolytic Agents