I was looking at the way some of our clients use different encounter forms for different types of visits and was wondering about the best ratio of space in the design for diagnoses vs. procedures - should an encounter form be mostly filled with procedure codes or ICD-9 codes? Or should it be 50/50?
I didn't reach any conclusions except to note that both sets of codes have a classic "long tail" distribution. A small segment of ICD-9 codes make up the biggest chunk of usage among our clients and then it's literally 1000s more that make up the rest.
It is obvious, though, that some of these codes are really generic - I don't like seeing that 382.9 up there so high. ICD-10 is going to be interesting!
|Top ICD-9 Codes for PCC Clients, 2009|
|ICD-9 Code||ICD title||Relative Volume||Running Total|
|V20.2||Routine infant or child health check||33.45%||33.45%|
|V04.81||Need for prophylactic vaccination and inoculation against influenza||7.95%||41.39%|
|465.9||Acute upper respiratory infections of unspecified site||2.78%||49.32%|
|V05.9||Need for prophylactic vaccination and inoculation against unspecified single disease||2.19%||51.50%|
|79.99||Unspecified viral infection||2.17%||53.67%|
|382.9||Unspecified otitis media||1.68%||57.05%|
|V05.3||Need for prophylactic vaccination and inoculation against viral hepatitis||1.51%||58.57%|
|34.0||Streptococcal sore throat||1.39%||59.96%|
|382.00||Acute suppurative otitis media without spontaneous rupture of eardrum||1.22%||61.18%|
|V06.1||Need for prophylactic vaccination and inoculation against diphtheria-tetanus-pertussis, combined [DTP] [DTaP]||1.05%||62.23%|
|487.1||Influenza with other respiratory manifestations||1.04%||63.26%|
|V03.82||Other specified vaccinations against streptococcus pneumoniae [pneumococcus]||1.02%||64.28%|
|V05.4||Need for prophylactic vaccination and inoculation against varicella||0.97%||66.22%|
|V04.89||Need for prophylactic vaccination and inoculation against other viral diseases||0.94%||67.17%|
|V70.0||Routine general medical examination at a health care facility||0.89%||68.05%|
|477.9||Allergic rhinitis, cause unspecified||0.77%||69.71%|
|461.9||Acute sinusitis, unspecified||0.75%||70.46%|
|V03.81||Other specified vaccinations against hemophilus influenza, type B [Hib]||0.73%||71.20%|
|V30.00||Single liveborn, born in hospital, delivered without mention of cesarean section||0.72%||71.91%|
There, that gets us to the top 71% or so. To get to 80%, I'd have to add another 20 codes. Top 90%? Another 100. Top 95%? 250. You get the picture, I am sure.