Validation of ICD-9-CM and ICD-10-CM Diagnosis Codes for Identifying Preterm Birth and Low Birthweight Infants in Florida Birth Hospitalizations, 2008-2018.

Rachel E Rutkowski, Jean Paul Tanner, Scott D Grosse, Norman J Waitzman, Russell S Kirby, Amanda L Elmore, Jason L Salemi

Abstract readValidation Study

PubMed Full text at PMC

In one paragraph

Article in Journal of registry management, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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7 authors.

Rachel E RutkowskiBirth Defects Surveillance Program, Chiles Center, College of Public Health, University of South Florida, Tampa, FL.

Jean Paul TannerBirth Defects Surveillance Program, Chiles Center, College of Public Health, University of South Florida, Tampa, FL.

Scott D GrosseNewborn Screening and Molecular Biology Branch, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA.

Norman J WaitzmanDepartment of Economics, University of Utah, Salt Lake City, Utah.

Russell S KirbyBirth Defects Surveillance Program, Chiles Center, College of Public Health, University of South Florida, Tampa, FL.

Amanda L ElmoreBirth Defects Surveillance Program, Chiles Center, College of Public Health, University of South Florida, Tampa, FL.

Jason L SalemiBirth Defects Surveillance Program, Chiles Center, College of Public Health, University of South Florida, Tampa, FL.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objective: To estimate the sensitivity and positive predictive value (PPV) of ICD-9-CM and ICD-10-CM diagnosis codes for identifying preterm birth (PTB) and low birthweight (LBW) infants in birth hospital discharge data, using birth certificate records as the reference standard. Methods: We conducted a population-based validation study of Florida live births from 2008-2018 using linked birth certificate and infant hospital discharge records. Birth certificate obstetric estimates and recorded birthweights served as the reference standards. We calculated sensitivity and PPV for Results: Among 2,166,535 infants, 10.3% were preterm and 8.7% LBW. PPV exceeded 92% for PTB and 97% for LBW in both coding eras. Sensitivity improved from 77.0% to 84.4% for PTB and from 73.3% to 76.9% for LBW after the ICD-10-CM transition. Sensitivity for diagnosis codes was notably lower nearest the binary classification thresholds for PTB (37 weeks) and LBW (2500 grams). Coding accuracy was higher in urban teaching hospitals compared to nonteaching or rural hospitals. Conclusions: Infant hospital discharge data can reliably identify markedly preterm or low-birthweight infants but may under-ascertain cases near classification thresholds. Researchers should quantify and adjust for these limitations, for example through quantitative bias analysis or sensitivity analyses to account for misclassification.

Indexed as

Infant, Low Birth WeightInternational Classification of DiseasesPremature BirthRegistriesAdultBirth CertificatesFemaleFloridaGestational AgeHospitalizationHumansInfant, NewbornMalePregnancySensitivity and Specificityaccuracygestational ageICD-10-CMlow birthweightpreterm

Identifiers

PMID42267112

PMCPMC13245670

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