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Barell Matrix— moving to ICD-10. Lois A. Fingerhut May 2004. Barell Matrix . Conceived for injury morbidity Codes based on ICD-9 CM Not useful for those not using ICD-9 CM. Barell Matrix . Why update to ICD-10? US Cost of Injury Study Multiple cause of injury death analysis

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Barell matrix moving to icd 10 l.jpg

Barell Matrix—moving to ICD-10

Lois A. Fingerhut

May 2004


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Barell Matrix

  • Conceived for injury morbidity

    • Codes based on ICD-9 CM

    • Not useful for those not using ICD-9 CM


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Barell Matrix

  • Why update to ICD-10?

    • US Cost of Injury Study

    • Multiple cause of injury death analysis

    • Used in both mortality and morbidity

      • Adaptable to different versions of clinical modifications


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Difficulties…

  • ICD-9 CM is not meant to crosswalk to ICD-10

  • ICD-9 and ICD-10 injury chapters differ!

    • ICD-9 main axis is nature of injury

    • ICD-10 main axis is body region of injury

      • Hence translation is not straightforward

  • Comparability study in US not completed for injury diagnosis codes


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More difficulties…

  • Traumatic brain injury codes are particularly problematic

  • Morbidity codes are more detailed than mortality codes because more information is on medical record than on death certificate


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Nonetheless…

  • December 2002 I received an email from Richard Hockey in Australia

    • NDS-IS Nature/Body part matrix from ICD9-AM to ICD10-AM

    • Categories are those used in NDS-IS V2.1 developed by James Harrison

  • By July 2003 I produced a first draft based on ICD-10 S&T codes

    • Sent to Limor, Ellen, Lee, James & Richard for comment

    • Needs more comment!!


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Comments

  • ICD-10 is not “designed” for a single code

    • Perhaps pairs of codes should be used

  • S09.9 – Australian example:

    • ICD-9 854 was used in ED for any suspected intracranial head injury and its nearest equivalent in 10 is S09.9 unspecified injury of head


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Progress to date

  • Sept 2003: Ted Miller (US Cost of Injury expert) programmed SAS codes for draft matrix

  • US NHTSA wants a matrix (have been emailing me for more than a year!)

  • What to code: Entity vs Record axis- another decision

  • Any vs total mention (from US multiple cause file)

  • CDC-NCIPC wants TBI comparable codes

  • May 2004- presentation to NCIPC on TBI comparability


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What next?

  • Draft matrix needs more international review and comment

  • Mortality

    • 1st listed code?

    • Main injury?

    • Multiple injuries?

  • Morbidity

    • What clinical versions are being used?

    • Are they compatible with ICD-10?