2013 ICD9 Analysis

Whew, that was quite an interesting time at AAP NCE – thanks to all of you who spent time with us (you know who you are). I really appreciate the new Hawaiian shirt I received from my friends.

Our developers have been busy working on ICD-10 prep, which means I got to see a file of PCC client ICD-9 usage float past me.  The results were interesting and worth sharing.  Let’s start with the top 25 ICD9 codes used by PCC clients over the last 12 months:

ICD9 Diag Name % of Total Running % of Total
V20.2 Routine child health exam 31.18% 31.18%
462 Acute pharyngitis 5.72% 36.89%
465.9 Acute URI NOS 3.89% 40.79%
V04.81 Vaccine for influenza 3.58% 44.37%
382.9 Otitis media NOS 2.86% 47.23%
V05.9 Vaccine for single dis NOS 2.43% 49.66%
079.99 Viral infection NOS 1.99% 51.65%
034.0 Strep sore throat 1.62% 53.27%
382.00 Ac supp otitis media NOS 1.56% 54.83%
477.9 Allergic rhinitis NOS 1.36% 56.19%
V05.3 Need prphyl vc vrl hepat 1.26% 57.45%
780.60 Fever NOS 1.19% 58.64%
V06.1 Vaccination for DTP-DTaP 1.07% 59.71%
V03.82 Need vac strptcs pneumni b 1.07% 60.78%
786.2 Cough 1.05% 61.83%
461.9 Acute sinusitis NOS 0.91% 62.74%
V30.00 Single lb in-hosp w/o cs 0.87% 63.61%
V06.8 Vac-dis combinations NEC 0.82% 64.43%
V03.81 Nd vac hmophlus inflnz b 0.80% 65.22%
493.90 Asthma NOS 0.78% 66.00%
V04.0 Vaccine for poliomyelitis 0.68% 66.68%
490 Bronchitis NOS 0.65% 67.33%
V06.4 Vac-measle-mumps-rubella 0.64% 67.97%
V04.89 Vaccn/inoc viral dis NEC 0.63% 68.60%
558.9 Noninf gastroenterit NEC 0.62% 69.22%

Two things jump out at me.  First, well visit ICD9s have a much great representation than I imagined.  Second, it’s clear that there is a massive diagnostic spectrum in pediatrics!  In fact, here’s some interesting data – we counted over 10,000 valid ICD9s recorded by our clients.  The top 75 ICD9s cover about 85% of all ICD9s counted.  To get to 95%, you have to go to #346 (which happens to be 382.3, or one of the Otitis family).  Once you cross the top 1000 ICD9s you are still at about 98%, and that’s still 1000s of recorded codes.

What if we eliminate all those pesky V-codes and see why kids are actually visiting pediatric practices?

ICD9 Diag Name % of Total Running % of Total
462 Acute pharyngitis 10.63% 10.63%
465.9 Acute uri NOS 7.24% 17.87%
382.9 Otitis media NOS 5.32% 23.20%
079.99 Viral infection NOS 3.70% 26.90%
034.0 Strep sore throat 3.02% 29.91%
382.00 Ac supp otitis media NOS 2.91% 32.82%
477.9 Allergic rhinitis NOS 2.53% 35.36%
780.60 Fever NOS 2.20% 37.56%
786.2 Cough 1.95% 39.52%
461.9 Acute sinusitis NOS 1.68% 41.20%
493.90 Asthma NOS 1.45% 42.65%
490 Bronchitis NOS 1.21% 43.86%
558.9 Noninf gastroenterit NEC 1.16% 45.02%
692.9 Dermatitis NOS 1.12% 46.14%
V05.8 Vaccin for disease NEC 0.93% 47.06%
599.0 Urin tract infection NOS 0.90% 47.96%
466.0 Acute bronchitis 0.85% 48.81%
789.00 Abdmnal pain unspcf site 0.79% 49.59%
493.00 Extrinsic asthma NOS 0.76% 50.35%
388.70 Otalgia NOS 0.73% 51.09%
464.4 Croup 0.73% 51.81%
463 Acute tonsillitis 0.72% 52.53%
487.1 Flu w resp manifest NEC 0.69% 53.22%
486 Pneumonia, organism NOS 0.68% 53.90%
314.01 Attn deficit w hyperact 0.65% 54.55%

25 ICD9 codes gets us to about 55% of the spectrum of your care.

All I need is one person to ask and I will re-count based on just the first 3 ICD9 digits which will allow a much more broad analysis – for example, it’d group all the otitises (what’s the plural of otitis? otiti?).

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