ICD-10 Codes for Uveitis: EHR Discrepancies
JAMA Ophthalmology, August 2021
McKay et al. set out to assess the degree of uniformity in uveitis diagnosis and ICD-10 coding among institutions that used the same electronic health record (EHR) system. They found that although uveitis-related ICD-10 code mapping was highly uniform among the institutions, some discrepancies did exist.
For this study, participants were drawn from ophthalmology departments of five institutions that use the Epic EHR system. The investigators recorded ICD-10 codes associated with 54 uveitis-related diagnostic terms that made up a diverse anatomic and etiologic set of uveitic diseases. For each center, data were collected within a single day, with the exception of longitudinal analyses conducted at two centers to explore mapping discrepancies for intermediate uveitis.
The study was conducted between Sept. 14 and Oct. 9, 2020. The 54 uveitis-related diagnostic terms were queried within the Epic EHR system, and the corresponding ICD-10 codes were evaluated. The main outcomes were the degree of uniformity for uveitis clinical concepts and associated codes.
Among the five institutions, there was perfect agreement for 52 of the 54 diagnostic terms. Two terms—“juvenile idiopathic arthritis associated chronic uveitis” and “intermediate uveitis”—had coding differences. These discrepancies appear to be related to a recent update in diagnostic mapping in Epic, the authors said. In addition, a substantial number of commonly used diagnostic terms were not mapped to specific codes in Epic’s diagnostic dictionary.
Overall, the findings suggest that “efforts should be considered to standardize mapping, track and disseminate information regarding impactful changes with time, and improve precision and coverage for uveitic conditions,” the authors concluded. (Also see related commentary by Karandeep Singh, MD, and Maria A. Woodward, MD, MSc, in the same issue.)
The original article can be found here.