OBJECTIVE: To determine the positive predictive value of ICD-9-CM coding of acute myocardial infarction and cardiac procedures.
METHODS: Using chart-abstracted data as the standard, we examined administrative data from the Veterans Health Administration for a national random sample of 5,151 discharges.
MAIN RESULTS: The positive predictive value of acute myocardial infarction coding in the primary position was 96.9%. The sensitivity and specificity of coding were, respectively, 96% and 99% for catheterization, 95.7% and 100% for coronary artery bypass graft surgery, and 90.3% and 99.7% for percutaneous transluminal coronary angioplasty.
CONCLUSIONS: The positive predictive value of acute myocardial infarction and related procedure coding is comparable to or better than previously reported observations of administrative databases.
DRG information systems medical records databases myocardial infarction
This is a preview of subscription content, log in to check access.
Public Health Service, US Department of Health and Human Services. International Classification of Diseases, Ninth Revision, Clinical Modification, Washington, DC: US Government Printing Office; 1980. Publication (PHS) 80-1260:366–7.Google Scholar
Jollis JG, Ancukiewicz M, DeLong ER, Pryor DB, Muhlbaier LH, Mark DB. Discordance of databases designed for claims payment versus information systems: implications for outcomes research. Ann Intern Med. 1993;119:844–50.PubMedGoogle Scholar
Assaf AR, Lapane KL, McKenney JL, Carleton RA. Possible influence of the prospective payment system on the assignment of discharge diagnoses for coronary heart disease. N Engl J Med. 1993;329:931–5.PubMedCrossRefGoogle Scholar
Roos LL, Roos NP, Cageorge SM, Nicol JP. How good are the data? Reliability of one health care data bank. Med Care. 1982;20:266–76.PubMedCrossRefGoogle Scholar
Iezzoni L. Using administrative diagnostic data to assess the quality of hospital care: pitfalls and potential of ICD-9-CM. Int J Technol Assess Health Care. 1990;6:272–81.PubMedCrossRefGoogle Scholar
Dans P. Looking for answers in all the wrong places. Ann Intern Med. 1993;119:855–6.PubMedGoogle Scholar
Romano PS, Mark DH. Bias in the coding of hospital discharge data and its implications for quality assessment. Med Care. 1994;32:81–90.PubMedCrossRefGoogle Scholar
Demlo LK, Campbell PM, Brown SS. Reliability of information abstracted from patient’s medical records. Med Care. 1978;16:995–1005.PubMedCrossRefGoogle Scholar
Fisher ES, Whaley FS, Krushat WM, et al. The accuracy of Medicare’s hospital claims data: progress has been made, but problems remain. Am J Public Health. 1992;82:243–8.PubMedGoogle Scholar
Iezzoni LI, Burnside S, Sickles L, et al. Coding of acute myocardial infarction: clinical and policy implications. Ann Intern Med. 1988;109:745–51.PubMedGoogle Scholar
Schiff GD, Yaacoub AS. The diagnostic coding of myocardial infarction. Ann Intern Med. 1988;109:745–51. Letter.Google Scholar
Daley J, Jencks SF, Draper D, et al. Predicting hospital-associated mortality for Medicare patients: a method for patients with stroke, pneumonia, acute myocardial infarction, and congestive heart failure. JAMA. 1988;260:3617–24.PubMedCrossRefGoogle Scholar
Kennedy GT, Stern MP, Crawford MH. Miscoding of hospital discharges as acute myocardial infarction: implications for surveillance programs aimed at elucidating trends in coronary artery disease. Am J Cardiol. 1984;53:1000–2.PubMedCrossRefGoogle Scholar
Reznik RB, Goldstein GB, Ring I, Berry G. The determination of the incidence of acute myocardial infarction from hospital morbidity records. J Chronic Dis. 1984;9/10:733–42.CrossRefGoogle Scholar
Nova Scotia-Saskatchewan Cardiovascular Epidemiology Group. Estimation of the incidence of acute myocardial infarction using record linkage: a feasibility study in Nova Scotia and Saskatchewan. Can J Public Health. 1989;80:412–7.Google Scholar
van Walraven C, Wang B, Ugnat AM, Naylor CD. False-positive coding for acute myocardial infarction on hospital discharge records: chart audit results from a tertiary centre. Can J Cardiol. 1990;6:383–6.PubMedGoogle Scholar
Wright SM, Daley J, Peterson ED, Thibault GE. Outcome of acute myocardial infarction in the Department of Veterans Affairs: does regionalization of health care work? Med Care. 1997;35:128–41.PubMedCrossRefGoogle Scholar
Jencks SF. HCFA’s Health Care Quality Improvement Program and the Cooperative Cardiovascular Project. Ann Thorac Surg. 1994;58:1858–62.PubMedCrossRefGoogle Scholar
Ellerbeck EF, Jencks SR, Randford MJ, et al. Quality of care for Medicare patients with acute myocardial infarction: report on a four state pilot of the Cooperative Cardiovascular Project. JAMA. 1995;273:1509–14.PubMedCrossRefGoogle Scholar
Hunter-Young NL, Hamann C, Cagan M, Daley J, Thibault GE. Validity and reliability of coding in the Veterans Health Administration Patient Treatment File for veterans with acute myocardial infarctions. Abstract presented at the VA HSR&D annual meeting, April 1994.Google Scholar