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. 2015 Jan-Feb;30(1):52-7.
doi: 10.1177/1062860613512518. Epub 2013 Dec 16.

Validity of ICD-9-CM codes for the identification of complications related to central venous catheterization

Melissa H Tukey  1 , Ann M Borzecki  2 , Renda Soylemez Wiener  3
Affiliations

Validity of ICD-9-CM codes for the identification of complications related to central venous catheterization

Melissa H Tukey et al. Am J Med Qual. 2015 Jan-Feb.

Abstract

Two complications of central venous catheterization (CVC), iatrogenic pneumothorax and central line-associated bloodstream infection (CLABSI), have dedicated International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes. Despite increasing use of ICD-9-CM codes for research and pay-for-performance purposes, their validity for detecting complications of CVC has not been established. Complications of CVCs placed between July 2010 and December 2011 were identified by ICD-9-CM codes in discharge records from a single hospital and compared with those revealed by medical record abstraction. The ICD-9-CM code for iatrogenic pneumothorax had a sensitivity of 66.7%, specificity of 100%, positive predictive value (PPV) of 100%, and negative predictive value (NPV) of 99.5%. The ICD-9-CM codes for CLABSI had a sensitivity of 33.3%, specificity of 99.0%, PPV of 28.6%, and NPV of 99.2%. The low sensitivity and variable PPV of ICD-9-CM codes for detection of complications of CVC raise concerns about their use for research or pay-for-performance purposes.

Keywords: ICD-9-CM codes; bacteremia; central venous catheters; pneumothorax.

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