Validation of the V66.7 Code for Palliative Care Consultation in a Single Academic Medical Center. Academic Article uri icon

Overview

abstract

  • BACKGROUND: Use of administrative data to study the effectiveness of specialized palliative care is limited by the lack of a reliable method to identify patients receiving palliative care consultation. The International Classification of Diseases, Ninth Revision (ICD-9) code V66.7 has been used, but its validity for this purpose is unknown. OBJECTIVE: To examine the validity of the ICD-9 code V66.7 for identifying whether hospitalized patients received palliative care consultation. DESIGN: Retrospective cohort study. SETTING/SUBJECTS: All patients of age ≥18 years admitted to a single academic medical center between August 2013 and August 2015. MEASUREMENTS: Sensitivity and specificity of the V66.7 code for palliative care consultation for all patients and several a priori identified subgroups. The reference standard was the presence of a palliative care consultation note in the electronic medical record. RESULTS: Of 100,910 admissions, 1999 received a palliative care consultation (2.0%) and 1846 (1.8%) had usage of the V66.7 code. Sensitivity and specificity for the V66.7 code were 49.9% and 99.1%, respectively. Sensitivity was considerably higher for certain subgroups, such as patients with dementia (76.3%) and metastatic cancer (66.3%); addition of age restrictions further improved sensitivity while maintaining high specificity. Specificity was substantially lower for patients who died during hospitalization (sensitivity 53.9%, specificity 75.1%). CONCLUSIONS: In a single center, the ICD-9 code V66.7 had poor sensitivity and high specificity for identifying hospitalized patients who received a palliative care consultation. Appropriate use of this code for this purpose should take these characteristics into consideration.

publication date

  • December 7, 2016

Research

keywords

  • Clinical Coding
  • Electronic Health Records
  • Inpatients
  • International Classification of Diseases
  • Palliative Care
  • Referral and Consultation

Identity

PubMed Central ID

  • PMC5385421

Scopus Document Identifier

  • 85017138978

Digital Object Identifier (DOI)

  • 10.1089/jpm.2016.0363

PubMed ID

  • 27925839

Additional Document Info

volume

  • 20

issue

  • 4