Validation of body mass index (BMI)-related ICD-9-CM and ICD-10-CM administrative diagnosis codes recorded in US claims data

Pharmacoepidemiology and Drug Safety
Eric M AmmannStephen S Johnston

Abstract

To quantify the sensitivity and positive predictive value (PPV) of body mass index (BMI)-related ICD-9-CM and ICD-10-CM diagnosis codes in claims data. De-identified electronic health record (EHR) and claims data were obtained from the Optum Integrated Claims-Clinical Database for cross-sections of commercial and Medicare Advantage health plan members age ≥ 20 years in 2013, 2014, and 2016. In each calendar year, health plan members' BMI as coded in the insurance claims data (error-prone measure) was compared with their BMI as recorded in the EHR (gold standard) to estimate the sensitivity and PPV of BMI-related ICD-9-CM and ICD-10-CM diagnosis codes. The unit of analysis was the person-year. The study sample included 746 763 distinct health plan members who contributed 1 116 283 eligible person-years (median age 56 years; 57% female; 65% commercially insured and 35% with Medicare Advantage). BMI-related diagnoses were coded for 14.6%. The sensitivity of BMI-related diagnoses codes for the detection of underweight, normal weight, overweight, and obesity was 10.1%, 3.7%, 6.0%, and 25.2%, and the PPV was 49.0% for underweight, 89.6% for normal weight, 73.4% for overweight, and 92.4% for obesity, respectively. The sensitivity of B...Continue Reading

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Citations

Feb 13, 2018·Population Health Metrics·Alejandro Álvaro-MecaUNKNOWN Group of Biomedical Research in Critical Care Medicine (BioCritic)
Mar 18, 2020·Paediatric and Perinatal Epidemiology·Elizabeth Wall-WielerSuzan L Carmichael
Jan 4, 2018·Current Medical Research and Opinion·Alpesh N AminShirin V Sundar
Sep 11, 2019·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·Elsie RizkEzekiel Fink
Aug 18, 2020·American Journal of Cardiovascular Drugs : Drugs, Devices, and Other Interventions·Veronica AshtonKenneth T Moore
Aug 6, 2019·American Journal of Hematology·Kristen M SanfilippoBrian F Gage
Jun 22, 2020·Journal of Thrombosis and Thrombolysis·Ilias NikolakopoulosAlex C Spyropoulos
Oct 29, 2020·Canadian Journal of Diabetes·Kristin K ClemensBlayne Welk
Aug 12, 2021·Journal of Comparative Effectiveness Research·François LalibertéJeffrey S Berger
Aug 3, 2021·Diabetes, Obesity & Metabolism·Karine SuissaElisabetta Patorno
Aug 4, 2021·American Journal of Epidemiology·Abigail R CartusLisa M Bodnar
Oct 18, 2021·American Journal of Obstetrics & Gynecology MFM·Elizabeth A SuarezCatherine Corey
Dec 17, 2021·Chest·Michael V GenuardiSanjay R Patel

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