ICDPICR does not recognize initial encounter ICD10-CM injury codes ending with "B" or "C"

[aldavidson320]

I am using these tables to help identify trauma ICD codes and their body regions/severity level for each ICD10 code and I notice that some tables with the complete 7 character codes do not include codes that have a 7th character designation of "B" for open fractures. Were these missed or do the tables need to be updated?

[aldavidson320]

There are also codes with a 7th character of "C" also that are initial encounters for open type of fractures; not all initial encounter codes have "A" as their 7th character. Some S72 and S82 codes for example.

[ablack3]

Thanks very much for pointing these issues out. These codes were missed and we will add them in the next major update to icdpicr. I'll leave the issue open until it is fixed.

[nvpmd]

Any idea when this bug will be fixed?
Some of the following codes are still missing:
S02.1 – S02.9
S12.0 – S12.6
S22, S32, S42
S49.0 – S49.1
S52, S62, S72, S82, S92 and S99
(also T30-32 codes don't have any letters at all)
I think that's about it.

[ablack3]

Any idea when this bug will be fixed?

Dr. Clark and I are working on an update to ICDPIC but the COVID19 research has taken precedent at the moment. If I knew the correct AIS and body region that these codes should get mapped to then it would be easy to add them. I think that the reason they are not in ICDPIC is because they did not appear in the training data. Fixing this is definitely on the list but we probably won't get to it until after COVID19 because it involves retraining the model. If you see an easy way to add these codes I'm happy to make the change though.

It does look like these codes are included in idcpic but for some reason on are being mapped properly. I will look into it more this weekend.

[ablack3]

One issue is that ICD-10 codes are assumed to be 7 characters long.

This code works

df <- data.frame(dx1 = "S02.2XXA")
cat_trauma(df, dx_pre = "dx")

While this does not

df <- data.frame(dx1 = "S02.2")
cat_trauma(df, dx_pre = "dx")

The code that would need to change is here:

icdpicr/R/cat_trauma.R

Line 219 in 03f3007

else if(nchar(s) != 7) ret_val <- ""

However I'm not sure yet if removing this requirement would cause other issues with ICDPIC.

[jessyjkn]

I wanted to add on to the list of icd10 codes that did not have an AIS calculated:
T07
T14 (e.g. T1490, T1491, T148)
A couple of T2's (e.g. T24211A, T2652XA, etc...)
S20 (e.g. S20352A), S30 (e.g. S30814A), S63 (e.g. S63682A), S85 (e.g. S85802A), S90 (e.g. S90912A), S46 (e.g. S46002A)

I believe there a couple more valid codes that were missing but I wasn't able to test every code.

Additionally, the Healthcare Cost and Utilization Project has a list of valid ICD10 trauma codes. They considered a couple more ICD10 codes for trauma. I will provide the text and link here:

Link: https://www.hcup-us.ahrq.gov/db/vars/siddistnote.jsp?var=i10_multinjury

Text:

"Starting in Data Year 2017 ICD-10-CM Diagnosis Codes Used to Identify Injury Discharges

Below is a list of the ICD-10-CM diagnosis codes used to identify injuries starting in data year 2017, only codes indicating an initial encounter (with a 7th character of A, B, C, or missing) are considered:

• S00-S99 series: Injuries to the head; neck; thorax; abdomen, lower back, lumbar spine, pelvis and external genitals; shoulder and upper arm; elbow and forearm; wrist, hand and fingers; hip and thigh; knee and lower leg; ankle and foot.
• T07-T34 series: Injuries involving multiple body regions; injury of unspecified body region; effects of foreign body entering through natural orifice; burns and corrosions of external body surface, specified by site; burns and corrosions confined to eye and internal organs; burns and corrosions of multiple and unspecified body regions; frostbite
• T36-T50 series with a 6th character of 1, 2, 3, or 4: Poisoning by drugs, medicaments, and biological substances
• T36.9, T37.9, T39.9, T41.4, T42.7, T43.9, T45.9, T47.9, and T49.9 with a 6th character of X and a 5th character of 1, 2, 3, or 4: Poisoning by drugs, medicaments, and biological substances
• In the 2017 NEDS, the criteria to identify injuries was missing this range of codes. The exclusion of these codes resulted in 3,775 records (0.01 percent of the 2017 NEDS) as not being identified as injury-related records.
• T51-T76 series: Toxic effects of substances chiefly nonmedicinal as to source; other and unspecified effects of external causes: radiation sickness, unspecified; effects of heat and light; hypothermia; other effects of reduced temperature; effects of air pressure and water pressure; asphyxiation; effects of other deprivation; adult and child abuse, neglect and other maltreatment, confirmed; other and unspecified effects of other external causes; adult and child abuse, neglect and other maltreatment, suspected
• T79 series: Certain early complications of trauma, not elsewhere classified
• M97 series (valid as of October 1, 2016) or T8404 series (valid prior to October 1, 2016): Periprosthetic fracture around internal prosthetic joint
• O9A2-O9A5 series: Injury, poisoning, physical abuse, sexual abuse, psychological abuse, and other consequences of external causes complicating pregnancy, childbirth and the puerperium

It should be noted that ICD-10-CM codes in the range of T36-T50 with a 6th character of 5 or 6 are excluded from the criteria to identify injuries. These codes are specific to adverse effects and underdosing of drugs, medicaments and biological substances."

Thanks Adam for your work on calculating severity scores for ICD10. It's fantastic!

[jessyjkn]

Hello Adam, I wanted to follow up. Most of the codes I mentioned above have had an AIS assigned to them. Thanks for updating the R package!

I found a couple more codes that were not assigned AIS scores (e.g. T24619A and T23639A). Were these codes not assigned because they indicated corrosion?