title: Validity of ICD-9-CM codes for the identification of complications related to central venous catheterization.
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.
authors.affiliation: Boston University, Boston, MA mtukey@bu.edu.
authors.forename: Melissa H
authors.initials: MH
authors.lastname: Tukey
authors.affiliation: Boston University, Boston, MA ENRM VA Hospital, Bedford, MA Boston University School of Public Health, Boston, MA.
authors.forename: Ann M
authors.initials: AM
authors.lastname: Borzecki
authors.affiliation: Boston University, Boston, MA ENRM VA Hospital, Bedford, MA.
authors.forename: Renda Soylemez
authors.initials: RS
authors.lastname: Wiener
mesh_terms: D055499:Catheter-Related Infections / Q000209:etiology*; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D003430:Cross-Sectional Studies; D057286:Electronic Health Records; D006801:Humans; D007049:Iatrogenic Disease; D038801:International Classification of Diseases / Q000592:standards*; D011030:Pneumothorax / Q000209:etiology*; D015203:Reproducibility of Results; D012189:Retrospective Studies
keywords: ICD-9-CM codes; bacteremia; central venous catheters; pneumothorax