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Accuracy of International Classification of Diseases-10 Codes for Cirrhosis and Portal Hypertensive Complications

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Abstract

Background and Aims

International Classification of Diseases (ICD)-10 codes may correspond to cirrhosis diagnosis. However, these codes have not been as well studied as ICD-9 codes. We aimed to evaluate the positive predictive value (PPV) and specificity of ICD-10 codes for cirrhosis.

Methods

We conducted a single-center retrospective study of patients in Michigan Medicine (Ann Arbor, MI, USA). We evaluated patients with at least one of 28 ICD-10 codes for cirrhosis and randomly selected controls for the presence of cirrhosis and/or portal hypertensive complications.

Results

Among 1317 patients with at least one ICD-10 code consistent with cirrhosis and/or portal hypertension, 796 had confirmed cirrhosis. After excluding ICD-10 codes found in < 10 patients, we evaluated the PPV of the 19 remaining codes. Of these, 15 had a high PPV for cirrhosis (> 80%), including codes for cirrhosis itself, gastroesophageal varices, hepatic encephalopathy, and other portal hypertensive complications. Specificity of ICD codes for cirrhosis for these 15 codes was high (> 94% for all). PPV and specificity were high across liver disease etiologies. Among patients without portal hypertension, PPVs of ICD-10 codes for cirrhosis were lower but still > 80% for the most common codes. PPVs of most codes for portal hypertensive complications were > 70%. Defining cirrhosis based on the presence of any of the 15 codes resulted in a PPV of 86% and by two different codes, a PPV 94%.

Conclusions

ICD-10 codes for cirrhosis can accurately identify patients with cirrhosis with or without portal hypertensive complications.

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Data availability

Data are available upon reasonable request.

Abbreviations

ICD:

International Classification of Diseases

MGI:

Michigan Genomics Initiative

PPV:

Positive predictive value

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Acknowledgments

VLC was supported in part by a Clinical, Translational and Outcomes Research Award from the American Association for the Study of Liver Diseases.

Funding

This study was funded in part by a Clinical, Translational and Outcomes Research Award from the American Association for the Study of Liver Diseases to VLC.

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Author notes

  1. Daniel A. Burkholder and Isabel J. Moran are contributed equally to this study

Authors and Affiliations

  1. Department of Internal Medicine, University of Michigan Health System, Ann Arbor, MI, USA

    Daniel A. Burkholder & Jacob V. DiBattista

  2. Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan Health System, Ann Arbor, MI, USA

    Isabel J. Moran, Anna S. Lok, Neehar D. Parikh & Vincent L. Chen

Authors
  1. Daniel A. Burkholder
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  2. Isabel J. Moran
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  3. Jacob V. DiBattista
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  5. Neehar D. Parikh
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  6. Vincent L. Chen
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Contributions

DAB and IJM contributed to data collection, data analysis, and manuscript drafting. JVD collected the data. ASL and NDP performed a critical review of the manuscript. VLC helped in study design, data analysis, and critical review of the manuscript.

Corresponding author

Correspondence to Vincent L. Chen.

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Conflict of interest

Daniel Burkholder, Isabel Moran, Jacob DiBattista, Anna Lok, Neehar Parikh, and Vincent Chen have no personal conflicts of interest relevant to this manuscript to report.

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Burkholder, D.A., Moran, I.J., DiBattista, J.V. et al. Accuracy of International Classification of Diseases-10 Codes for Cirrhosis and Portal Hypertensive Complications. Dig Dis Sci 67, 3623–3631 (2022). https://doi.org/10.1007/s10620-021-07282-x

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  • DOI: https://doi.org/10.1007/s10620-021-07282-x

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