ArticlePharmacoepidemiology and drug safety2019
Assessment of ICD-10-CM code assignment validity for case finding of outpatient anticoagulant-related bleeding among Medicare beneficiaries.
Article in Pharmacoepidemiology and drug safety, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 3 of them syntheses that pooled it.
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Who cites it
28 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Comparing the efficacy and safety of direct oral anticoagulants with vitamin K antagonists in dialysis patients with nonvalvular atrial fibrillation: a systematic review and meta-analysis.Clinical research in cardiology : official journal of the German Cardiac Society · 2026Pooled it
- Validity and reliability International Classification of Diseases-10 codes for all forms of injury: A systematic review.PloS one · 2024Pooled it
- Risk Factors for Bleeding and Clinical Ineffectiveness Associated With Clopidogrel Therapy: A Comprehensive Meta-Analysis.Clinical and translational science · 2021Pooled it
- Clinically Relevant Bleeding in Individuals With Cancer: Insights From a Nationwide Cohort Study.American journal of hematology · 2026Article
- Validity of ICD-10 codes for identifying gastrointestinal bleeding in anticoagulated patients: an encounter-level diagnostic accuracy study.Journal of thrombosis and thrombolysis · 2026Article
- Risk factors for anticoagulant-related bleeding in cancer: traditional and cancer-specific factors.Blood vessels, thrombosis & hemostasis · 2026Article
- Detection of Antithrombotic-Related Bleeding in Older Inpatients: Multicenter Retrospective Study Using Structured and Unstructured Electronic Health Record Data.Journal of medical Internet research · 2026Article
- Increasing risk of hemorrhage following concurrent use ofTherapeutic advances in drug safety · 2026Article
- Concomitant use of medical cannabis and drugs associated with risks of interaction in older patients: a longitudinal cohort study.Age and ageing · 2025Article
- ICD-10 code validation for gastrointestinal bleeding in patients receiving oral anticoagulation: nationwide cohort study.BMC gastroenterology · 2025Article
- Comparative safety and effectiveness of apixaban and rivaroxaban for treatment of cancer-associated venous thromboembolism: A retrospective cohort study.PLoS medicine · 2025Article
- Natural Language Processing andJMIR medical informatics · 2025Article
- Association between anticoagulant-related bleeding and mortality in patients with hematological malignancies and cancer-associated venous thromboembolism.Thrombosis research · 2025Article
- Real-world andexanet alfa utilization and the association between delay in administration due to hospital transfer and all-cause inpatient mortality.Research and practice in thrombosis and haemostasis · 2025Article
- Characterization of bleeding in thrombotic thrombocytopenic purpura in the precaplacizumab era: a retrospective nationwide analysis.Research and practice in thrombosis and haemostasis · 2025Article
- Guideline concordance of aspirin use for primary prevention in adult outpatients.Blood advances · 2024Article
- Tracheostomy Incidence and Complications: A National Database Analysis.Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery · 2024Article
- Predictors of Non-Variceal Hemorrhage in a National Cohort of Patients With Chronic Liver Disease.Journal of hematology · 2024Article
- Modest performance of risk-prediction models for anticoagulant-related bleeding in patients with chronic liver disease.Thrombosis research · 2024Article
- Hospital variation of outcomes in status epilepticus.Epilepsia · 2024Article
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Authors and funding
8 authors.
Funding
Abstract
purposeTo assess performance of International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) code assignments for identifying bleeding events resulting in emergency department visits and hospitalizations among outpatient Medicare beneficiaries prescribed anticoagulants.
methodsPerformance of 206 ICD-10-CM code assignments indicative of bleeding, five anticoagulant adverse effect/poisoning codes, and five coagulopathy codes (according to Medicare Parts A and B claims) as assessed among Medicare fee-for-service beneficiaries prescribed anticoagulants between October 1, 2015 and September 30, 2016 (according to Part D claims). Structured medical record review was the gold standard for validating the presence of anticoagulant-related bleeding. Sensitivity was adjusted to correct for partial verification bias due to sampling design.
resultsBased on the study sample of 1166 records (583 cases, 583 controls), 57 of 206 codes yielded the optimal performance for anticoagulant-related bleeding (diagnostic odds ratio, 51; positive predictive value (PPV), 75.7% [95% CI, 72.0%-79.1%]; adjusted sensitivity, 70.0% [95% CI, 63.2%-77.7%]). Codes for intracranial bleeding demonstrated the highest PPV (85.0%) and adjusted sensitivity (91.0%). Bleeding codes in the primary position demonstrated high PPV (86.9%), but low adjusted sensitivity (36.0%). The adjusted sensitivity improved to 69.5% when codes in a secondary position were added. Only one adverse effect/poisoning code was used, appearing in 7.8% of cases and controls (PPV, 71.4% and adjusted sensitivity, 6.8%).
conclusionsPerformance of ICD-10-CM code assignments for bleeding among patients prescribed anticoagulants varied by bleed type and code position. Adverse effect/poisoning codes were not commonly used and would have missed over 90% of anticoagulant-related bleeding cases.
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