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Using SAS® to Analyze ICD-9 and ICD-10 Diagnosis Codes Found in Administrative Health-Care Data Author Kathy Fraeman Subject Administrative health-care data including insurance claims data, electronic medical records (EMR) data, and hospitalization data contains standardized diagnosis codes to identify diseases and other medical conditions.
The SAS data set above can be generated from an Excel data file containing the coding algorithms. These ICD diagnosis codes included in the coding algorithm can then be converted into SAS code in many ways, from simple to complex, using data-driven programming.
approximately 13,000 different diagnosis codes, ICD-10 has defined approximately 68,000 different codes with the flexibility to add more new diagnosis codes as need. Both ICD-9 and ICD-10 diagnosis codes need to be stored as SAS character variables.
These disease definitions based on multiple ICD diagnosis codes, also known as coding algorithms, can either be hardcoded in a SAS program or defined externally from the programming.
Z02.71ICD-10 code Z02. 71 for Encounter for disability determination is a medical classification as listed by WHO under the range - Factors influencing health status and contact with health services .
R45. 88 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.
ICD-10 code R68. 89 for Other general symptoms and signs is a medical classification as listed by WHO under the range - Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified .
ICD-10 Code for Encounter for general adult medical examination without abnormal findings- Z00. 00- Codify by AAPC.
ICD-10 code R45. 850 for Homicidal ideations is a medical classification as listed by WHO under the range - Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified .
Self-injurious behavior (SIB), displayed by individuals with autism and intellectual disabilities, involves the occurrence of behavior that results in physical injury to one's own body. Common forms of SIB include, but are not limited to, head-hitting, head-banging and hand-biting.
R68. 89 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM R68. 89 became effective on October 1, 2021.
Code F41. 9 is the diagnosis code used for Anxiety Disorder, Unspecified. It is a category of psychiatric disorders which are characterized by anxious feelings or fear often accompanied by physical symptoms associated with anxiety.
NCD 190.15 In some patients presenting with certain signs, symptoms or diseases, a single CBC may be appropriate.
A screening colonoscopy should be reported with the following International Classification of Diseases, 10th edition (ICD-10) codes: Z12. 11: Encounter for screening for malignant neoplasm of the colon.
ICD-10 CM Guidelines, may be found at the following website: https://www.cdc.gov/nchs/icd/Comprehensive-Listing-of-ICD-10-CM-Files.htm.
For example, Z12. 31 (Encounter for screening mammogram for malignant neoplasm of breast) is the correct code to use when you are ordering a routine mammogram for a patient. However, coders are coming across many routine mammogram orders that use Z12. 39 (Encounter for other screening for malignant neoplasm of breast).
ICD-10 Code for Other problems related to lifestyle- Z72. 89- Codify by AAPC. Factors influencing health status and contact with health services.
Code 90834 is the most standard CPT code for psychotherapy sessions. This code should be in conjunction with the diagnostic code and treatment plan associated with Acute Stress Disorder or Post Traumatic Stress Disorder.
T71.162A162A - Asphyxiation due to hanging, intentional self-harm [initial encounter] T71. 162A - Asphyxiation due to hanging, intentional self-harm [initial encounter] is a topic covered in the ICD-10-CM.
ICD-10 code R06. 02 for Shortness of breath is a medical classification as listed by WHO under the range - Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified .
The SAS colon modifier, used as either “=:” or “in:”, is a very handy tool for analyzing diagnosis codes, especially because researchers are usually concerned with the first 3 or 4 characters of a diagnosis code variable. When used after “=” or “in”, the colon modifier looks at only the beginning values of a character variable and eliminates the need to use the SUBSTR function.
The International Classification of Diseases (ICD) is maintained by the World Health Organization (WHO) and is described by the WHO as the international “…standard diagnostic tool for epidemiology, health management and clinical purposes.” ICD diagnosis codes provide a standardized system for classifying diseases, and for classifying a variety of signs, symptoms, and external causes of injury or disease. These diagnosis codes are used administratively for medical reimbursement but are also used for health-related research. Researchers use ICD diagnosis codes to derive morbidity and mortality statistics, including the incidence and prevalence of disease.
Administrative health-care data – including insurance claims data, electronic medical records (EMR) data, and hospitalization data – contains standardized diagnosis codes to identify diseases and other medical conditions. These codes use the short-form name of ICD, which stands for International Classification of Diseases. Much of the currently available health-care data contains the ninth version of these codes, referred to as ICD-9. Although, the more recent 10th version, ICD-10, is becoming more common in health-care data. These diagnosis codes are typically saved as character variables, are often stored in arrays of multiple codes representing primary and secondary diagnoses and can be associated with either outpatient medical visits or inpatient hospitalizations. SAS® text processing functions, array processing, and the SAS colon modifier can be used to analyze the text of these codes and to identify similar codes or ranges of ICD codes. In epidemiologic analyses, groups of multiple ICD diagnosis codes are typically used to define more general comorbidities or medical outcomes. These disease definitions based on multiple ICD diagnosis codes, also known as coding algorithms, can either be hardcoded in a SAS program or defined externally from the programming. When coding algorithm definitions based on ICD codes are stored externally, the definitions can be read into SAS, transformed to SAS format, and dynamically converted into SAS programming statements.
In epidemiologic analyses, groups of multiple ICD diagnosis codes are typically used to define more general comorbidities or medical outcomes. These disease definitions based on multiple ICD diagnosis codes are known as “coding algorithms.” The lower case “x” included at the end of some of the diagnosis codes represent a case where any digit can be used in place of the “x”. These “x”s are sometimes referred to as “wild card” code definitions.
Coding algorithms using combinations of ICD diagnosis codes, like the examples shown in Table 3, are frequently used in health research studies. These algorithms are often unique to each study and frequently change during study development as new diagnosis codes are added, or existing diagnosis codes are modified or deleted. Although the SAS programmer is responsible for getting these coding algorithms in to the SAS programs and for ensuring the coding algorithm definitions remain current and up-to-date, the non-programming study scientists and researchers are usually the ones who define these coding algorithms and who make any subsequent modifications.
These disease definitions stored in macro variables can then be used in programming that identifies diagnosis codes in insurance claims data. If the disease definitions change in the external data file, such as an Excel file, then the programming will be automatically updated to the most recent definitions.