Use of ICD Codes Only Can Underestimate Falls in ER

With ICD-9 definition only, 19.6 percent of visits meeting chief complaint definition were missed

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TUESDAY, June 27, 2017 (HealthDay News) -- Identifying individuals in the emergency department who have fallen based on diagnosis codes alone underestimates the rate of falls, according to research published online June 21 in the Journal of the American Geriatrics Society.

Brian W. Patterson, M.D., M.P.H., from the University of Wisconsin-Madison, and colleagues conducted a retrospective electronic record review at an academic medical center emergency department. Two fall definitions were applied to the cohort of 23,880 older adults (an International Classification of Diseases, Ninth Revision [ICD-9]-based definition or chief complaint indicating a fall).

Using the most-inclusive definition (ICD-9 code or chief complaint indicating a fall), 18 percent of visits were fall related. The researchers found that 80 and 61 percent of these visits met the ICD-9 definition for a fall-related visit and the chief complaint definition, respectively. When applying the ICD-9 definition alone, 19.6 percent of visits meeting the chief complaint definition were missed. Encounters that were missed using the ICD-9 definition were less likely than those identified to lead to an admission (42.9 versus 54.4 percent, respectively).

"These findings call attention to the value of using chief complaint information to identify individuals who have fallen in the emergency department -- for research, clinical care, or policy reasons," the authors write.

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