title: Use of International Classification of Diseases, Ninth Revision, Clinical Modification, codes to identify inpatient fall-related injuries.
abstract: OBJECTIVE
  To compare falls and fall-related injuries that a fall evaluator or hospital incident report identified with injuries identified according to discharge International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes for the same set of inpatient episodes of care.
  
  
  METHODS
  Prospective, descriptive study.
  
  
  METHODS
  Sixteen adult general medical and surgical units in a major urban teaching hospital.
  
  
  METHODS
  All adults who sustained a fall with injury during a 5-year period (380 falls with injury).
  
  
  METHODS
  Falls that a fall evaluator or hospital incident report identified were classified according to their injury severity. Discharge abstracts provided diagnosis codes (ICD-9-CM) for the discharge, including fall-related injury codes.
  
  
  RESULTS
  Three hundred forty-three inpatient falls with injury (90.2%) resulted in temporary harm to the individual; the remaining 37 falls (9.8%) resulted in more-serious harm. Sixteen of the 37 falls with injury extending hospitalization or resulting in death were identified using Centers for Medicare and Medicaid Services (CMS)-targeted injury code ranges combined with present-on-admission indicators. Of the 21 falls with injury that were not identified, nine (42.9%) lacked documentation of any injury, and seven (33.3%) identified other injuries outside the CMS-targeted injury code ranges.
  
  
  CONCLUSIONS
  The CMS-targeted ICD-9-CM codes used to identify fall-related injuries in claims data do not always detect the most-serious falls.
authors: Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee.
authors: Teresa M
authors: TM
authors: Waters
authors: Methodist Healthcare, Memphis, Tennessee.
authors: A Michelle
authors: AM
authors: Chandler
authors: Vanderbilt University, Nashville, Tennessee.
authors: Lorraine C
authors: LC
authors: Mion
authors: Division of Statistics and Scientific Computation and Department of Integrative Biology, University of Texas at Austin, Austin, Texas.
authors: Michael J
authors: MJ
authors: Daniels
authors: Methodist Healthcare Foundation, Memphis, Tennessee.
authors: Lori A
authors: LA
authors: Kessler
authors: Department of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee.
authors: Stephen T
authors: ST
authors: Miller
authors: Geriatric Research, Education and Clinical Center, Malcom Randall Veterans Affairs Medical Center, Gainesville, Florida.|Department of Epidemiology, University of Florida, Gainesville, Florida.
authors: Ronald I
authors: RI
authors: Shorr
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000328:Adult; D000368:Aged; D005260:Female; D006784:Hospitals, Teaching; D006786:Hospitals, Urban; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data*; D038801:International Classification of Diseases; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014481:United States; D014947:Wounds and Injuries / Q000145:classification*
keywords: ICD-9-CM codes; fall-related injuries; hospital-acquired conditions; inpatient falls