Diagnosis and Condition Codes Clause Samples

Diagnosis and Condition Codes. The medical conditions and procedures reported by the Household Component respondent were recorded by the interviewer as verbatim text. Beginning FY16, ICD-9-CM codes (ICD9CODX) are no longer used and medical conditions now are coded to ICD-10-CM codes (ICD10CDX). Also beginning in FY16, condition names are no longer coded to procedure codes, and ICD9PROX has been dropped from the file. Professional coders followed specific guidelines in coding missing values to the ICD-10-CM diagnosis condition variable. ICD10CDX was coded -9 (Not Ascertained) where the verbatim text fell into one of three categories: (1) the text indicated that the condition was unknown (e.g., DK); (2) the text indicated the condition could not be diagnosed by a doctor (e.g., doctor doesn’t know); or (3) the specified condition was not codeable. If the text indicated a procedure and the condition associated with the procedure could be discerned from the text, the condition itself is coded. For example, “cataract surgery” is coded as the condition “other cataract” (ICD10CDX is set to code “H26”). If the condition could not be discerned (e.g. “outpatient surgery”), ICD10CDX is set to -9. Through FY15, the text strings were coded by professional coders to fully-specified ICD-9-CM codes, including medical condition and V codes (see Health Care Financing Administration, 1980). Condition names were coded to ICD-9-CM diagnosis codes (ICD9CODX), and to ICD-9- CM procedure codes (ICD9PROX) when applicable (the condition name indicated a procedure/surgery). Through FY15, ICD9CODX also was coded -9 if the specified condition was not codeable and a procedure could not be discerned from the text; if the verbatim text strictly denoted a procedure and not a condition, ICD9CODX was coded -1. In order to preserve confidentiality, all of the conditions provided on this file have been coded to 3-digit diagnosis code categories rather than the fully-specified ICD-10-CM code. For example, the ICD10CDX value of J02 “Acute pharyngitis” includes the fully-specified subclassifications J020 and J029; the value F31 “Bipolar disorder” includes the fully-specified subclassifications F3110 through F319. Table 1 in Appendix 2 provides unweighted and weighted frequencies for all ICD-10-CM condition code values reported on the file. Approximately 2 percent of the ICD- 10-CM codes on this file were edited further by collapsing two or more 3-digit codes into one 3- digit code. This includes clinically rare conditions that...