Transition to ICD-10 Diagnoses and Procedures in the HCSRN Virtual Data Warehouse

Background/Aims: Federal regulations require that all U.S. health care providers transition from ICD-9 to ICD-10 for diagnosis and hospital procedure coding on Oct. 1, 2015. The changes between the two versions are dramatic; the new version expands the number of diagnosis codes from about 13,000 to 68,000 and increases the number of procedure codes from approximately 4,000 to 90,000. These changes require programmers to modify their file-building software when creating the diagnosis and procedure tables in the Health Care Systems Research Network (HCSRN) Virtual Data Warehouse (VDW). We will describe the transition to ICD-10 diagnostic and procedure data in the VDW as well as development of data quality reports to check on completeness of ICD-10 conversion at the participating HCSRN sites. Methods: The ICD-10 transition team from Kaiser Permanente Northwest’s Center for Health Research worked with subject matter experts and research project staff to develop categories of ICD-9 and ICD-10 diagnosis and procedure codes that all signify the same general condition (e.g. diabetes, congestive heart failure). The team then developed a program that plots daily counts of patients with one or more of the codes in each category. These plots show the consistency of counts of patients within each category before and after the transition date for the two ICD coding systems. This program will be distributed to the HCSRN sites to use as an early warning system for issues in the transition and to validate the VDW tables. Sites shared their results with the HCSRN Utilization Work Group. Results: We expect to find that the counts of patients with specific ICD diagnosis and procedure categories are consistent before and after the transition to ICD-10 for most HCSRN sites. We also believe the monitoring reports will be useful for identifying issues early, which should prompt corrections to the VDW before research teams begin using ICD-10 data. Conclusion: We expect that HCSRN sites will use these reports to validate ICD-10 diagnostic and procedure data and demonstrate these data are ready to be used in the VDW. Research teams will need to create crosswalks between ICD-9 and ICD-10 data if their projects span Oct. 1, 2015