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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