Article Figures & Data
Figures
- Figure 1.
Mapping complexity. Each International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) diagnosis code was categorized into 1 of 5 categories. A: The blue circles represent ICD-9-CM codes and the purple circles represent International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) diagnosis codes. The smaller circles represent secondary codes that are related to the category but have separate analysis as a primary code elsewhere. The arrows between the circles represent the mapping by the GEM files provided by the government. Identity is the category where 1 code replaces another code. Class-to-subclass is where multiple ICD-10-CM codes are represented by a single ICD-9-CM diagnosis code. Additional documentation or detail is required. Subclass-to-class is where multiple ICD-9-CM codes are represented by a single ICD-10-CM code. Convoluted codes are nonreciprocal and have secondary codes confounding the diagnosis concepts. No mapping is where the GEM file does not provide a mapping to the ICD-10-CM codes. B: Categories represent the percentage of diagnosis codes used in the complete data set in each category.
- Figure 2.
Analysis of family medicine encounters. A: This graph analyzes all 39,251 encounters with family medicine physicians. The Diagnosis Codes graph counts each diagnosis code as a single value and categorizes all the codes as a percentage of the total number of codes. The Visits graph analyses all the visits for a specific diagnosis code and calculates a percentage of total number of visits. The simple diagnosis codes account for more visits than the convoluted codes. The Payments analysis takes the payments for each diagnosis code and categorizes them into the simple or convoluted diagnosis code category and divides by the total amount of reimbursement. B: A secondary analysis of all diagnosis codes used >25 times was performed and included a total of 26,156 visits. The percentages are nearly equivalent to the complete representation of visits.
Tables
- Table 1. Convoluted International Classification of Diseases, 9th Revision, Clinical Modification Codes with Clinically Incorrect Mappings to International Classification of Diseases, 10th Revision, Clinical Modification
ICD-9-CM Code ICD-9-CM Code Name 250.02* Type II diabetes mellitus (non-insulin dependent type) (NIDDM type) (adult-onset type) or unspecified type, uncontrolled, without mention of complication 625.9* Unspecified symptom associated with female genital organs 719.44* Joint pain—hand V06.8 Need for prophylactic vaccination and inoculation against other combinations of diseases V70.2 General psychiatric examination, other and unspecified 648.83 Abnormal glucose tolerance of mother, antepartum 919.4 Insect bite, nonvenomous, of other, multiple, and unspecified sites, without mention of infection 719.44 Joint pain—hand 780.79 Other malaise and fatigue 787.91 Diarrhea 292.0 Drug withdrawal 682.0 Cellulitis and abscess of face V07.31 Need for prophylactic fluoride administration 789.09 Abdominal pain, other specified site ↵* All International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes had two family medicine physicians agree the mapping was incorrect.
NIDDM, non-insulin-dependent diabetes mellitus.
959.01 Head injury NOS V07.31 Need for prophylactic fluoride administration V04.81 Need for prophylactic vaccination and inoculation against influenza 250.00 Type II diabetes mellitus (non-insulin dependent type) (NIDDM type) (adult-onset type) or unspecified type, not stated as uncontrolled, without mention of complication 799.9 Other unknown and unspecified cause of morbidity or mortality 250.02 Type II diabetes mellitus (non-insulin dependent type) (NIDDM type) (adult-onset type) or unspecified type, uncontrolled, without mention of complication V03.2 Need for prophylactic vaccination with tuberculosis (BCG) vaccine 292.0 Drug withdrawal V06.1 Need for prophylactic vaccination with combined diphtheria-tetanus-pertussis (DTP) (DTaP) vaccine 314.00 Attention deficit disorder of childhood without mention of hyperactivity V70.5 Health examination of defined subpopulations 314.01 Attention deficit disorder of childhood with hyperactivity 883.0 Open wound of fingers, without mention of complication 388.70 Otalgia NOS 959.4 Other and unspecified injury to hand, except finger 466.0 Acute bronchitis V03.82 Need for prophylactic vaccination against Streptococcus pneumoniae (pneumococcus) 518.81 Acute respiratory failure V05.3 Need for prophylactic vaccination and inoculation against viral hepatitis 558.9 Other and unspecified noninfectious gastroenteritis and colitis V06.8 Need for prophylactic vaccination and inoculation against other combinations of diseases 625.9 Unspecified symptom associated with female genital organs V70.2 General psychiatric examination, other and unspecified 626.4 Irregular menstrual cycle 789.09 Abdominal pain, other specified site; multiple sites 626.9 Unspecified disorders of menstruation and other abnormal bleeding from female genital tract 845.00 Sprain of ankle NOS 648.83 Abnormal glucose tolerance of mother, antepartum 919.4 Insect bite, nonvenomous, of other, multiple, and unspecified sites, without mention of infection 649.13 Obesity complicating pregnancy, childbirth, or the puerperium, antepartum condition or complication 959.3 Other and unspecified injury to elbow, forearm, and wrist 682.0 Cellulitis and abscess of face 959.5 Other and unspecified injury to finger 682.6 Cellulitis and abscess of leg, except foot V03.81 Need for prophylactic vaccination against Haemophilus influenzae, type B (Hib) 682.7 Cellulitis and abscess of foot, except toes V03.89 Need for other specified vaccination against single bacterial disease 715.90 Osteoarthrosis, unspecified whether generalized or localized, involving unspecified site V04.89 Need for prophylactic vaccination and inoculation against other viral diseases 729.5 Pain in limb V05.4 Need for prophylactic vaccination and inoculation against varicella 780.60 Fever NOS V06.4 Need for prophylactic vaccination with measles-mumps-rubella (MMR) vaccine 780.79 Other malaise and fatigue V06.9 Need for prophylactic vaccination with unspecified combined vaccine 781.0 Abnormal involuntary movements V70.0 Routine general medical examination at a health care facility 786.09 Other dyspnea and respiratory abnormality V70.3 Other general medical examination for administrative purposes 787.03 Vomiting alone V70.9 Unspecified general medical examination 787.91 Diarrhea 719.44 Joint pain—hand BCG, Bacillus Calmette–Guérin; NIDDM, non-insulin-dependent diabetes mellitus; NOS, not otherwise specified.
