Administrative billing codes accurately identified occurrence of electrical cardioversion and ablation/maze procedures in a prospective cohort study of atrial fibrillation patients

Clin Cardiol. 2017 Dec;40(12):1227-1230. doi: 10.1002/clc.22812. Epub 2017 Dec 6.


Background: Administrative billing codes for electrical cardioversion and ablation/maze procedures may be useful for atrial fibrillation (AF) research if the codes are accurate relative to medical record documentation.

Hypothesis: Administrative billing codes accurately identify occurrence of electrical cardioversion and ablation/maze procedures in AF patients.

Methods: We studied adults ages 30 to 84 who experienced new-onset AF between October 2001 and December 2004 in Group Health Cooperative (acquired by Kaiser Permanente in 2017), an integrated healthcare system in Washington state and northern Idaho. Using medical record review as the gold standard, we calculated sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for 3 administrative billing codes for electrical cardioversion and 3 codes for AF ablation/maze procedures.

Results: Of 1953 study participants, during a mean (SD) of 1.5 (0.7) years of follow-up after AF onset, 470 (24%) experienced electrical cardioversion and 44 (2%) experienced ablation/maze procedures, according to medical record review. For electrical cardioversion, individual codes had 7.7% to 76.4% sensitivity, >99% specificity, 83.7% to 96.5% PPV, and 77.3% to 93.0% NPV. Considering any of 3 codes (code 1 or code 2 or code 3) improved sensitivity to 84.9%. For ablation/maze, individual codes had 18.2% to 47.7% sensitivity, >99% specificity, 66.7% to 95.5% PPV, and >98% NPV. Considering any of 3 codes improved sensitivity to 84.1%.

Conclusions: Administrative billing data accurately identified electrical cardioversion and ablation/maze procedures and can be used instead of medical record review. Our findings apply to healthcare settings with available administrative billing databases.

Keywords: Atrial Fibrillation; Catheter Ablation; Current Procedural Terminology; Electric Countershock; International Classification of Diseases.

Publication types

  • Multicenter Study
  • Observational Study

MeSH terms

  • Administrative Claims, Healthcare / statistics & numerical data*
  • Adult
  • Aged
  • Aged, 80 and over
  • Atrial Fibrillation / economics
  • Atrial Fibrillation / therapy*
  • Catheter Ablation / economics*
  • Catheter Ablation / statistics & numerical data
  • Electric Countershock / economics*
  • Electric Countershock / statistics & numerical data
  • Female
  • Follow-Up Studies
  • Humans
  • Idaho
  • Male
  • Medical Records / statistics & numerical data*
  • Middle Aged
  • Pericardiectomy / economics*
  • Pericardiectomy / statistics & numerical data
  • Prospective Studies
  • Reproducibility of Results
  • Washington