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National Center for Health Statistics Barell Matrix— moving to ICD-10 Lois A. Fingerhut May 2004.

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Presentation on theme: "National Center for Health Statistics Barell Matrix— moving to ICD-10 Lois A. Fingerhut May 2004."— Presentation transcript:

1 National Center for Health Statistics Barell Matrix— moving to ICD-10 Lois A. Fingerhut May 2004

2 Barell Matrix Conceived for injury morbidity Codes based on ICD-9 CM Not useful for those not using ICD-9 CM

3 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

4 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

5 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

6 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!!

7 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

8 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

9 What next? Draft matrix needs more international review and comment Mortality 1 st listed code? Main injury? Multiple injuries? Morbidity What clinical versions are being used? Are they compatible with ICD-10?

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