Performance Measurement Network

Question: Denominator exclusion population ICD-9 CM diagnosis codes

The last bullet listing the excluded patient populations for CSTK 03 denominator refers to: pts with dx of TBI, unruptured AVM and non-traumatic subdural hematoma. While I agree with the codes in Table 8.2f for TBI, per the July and August 2015 specifications, I am unable to determine what the ICD-9 codes 435.9 and 437.8 in that same table are supposed to represent. As I am a former coder, I know that 435.9 is used to code an unspecified TIA, while 437.8 is an NEC (not elsewhere classified category, more of a catch-all code for a variety of conditions. Neither of these is correct for a non-traumatic subdural hematoma which is 432.1. Thus far, I have 5 cases for July and September that I feel are being erroneously excluded from CSTK-03 because of 435.9 being a secondary diagnosis.

From all the questions submitted, it does not appear anyone else has made this observation. I would hope that, if TJC agrees with removal of 435.9 and 437.8 to be replaced with 432.1.

Answer:

Thanks for the feedback on Table 8.2f. ICD-9 and ICD-10 codes were added for the following diagnoses based on feedback from other CSCs: Reversible cerebral vasoconstriction syndrome, and Cerebral amyloid angiopathy.

Since the conversion to ICD-10 codes was effective October, 1, 2015, the ICD-9 code tables will be removed completely with the next update to the Comprehensive Stroke Performance Measurement Implementation Guide. If you should have issues with specific ICD-10 codes, please let us know for future modification to Appendix A tables. Thank you.

Question Details
Focus area(s): Chart Abstracted Measure Specifications – Clinical
Related documents: CSTK, CSTK-03, ICD-9-CM Other Diagnosis Codes,
Manual: Current Manual (current data collection period; prior to data transmission)

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