A Validated Method to Identify Neuro-Ophthalmologists in a Large Administrative Claims Database

Feng, Yilin; Lin, Chun Chieh; Hamedani, Ali G.; Lott, Lindsey B. De

doi:10.1097/wno.0000000000001794

Journal of Neuro-Ophthalmology

2023

DOI: 10.1097/wno.0000000000001794

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A Validated Method to Identify Neuro-Ophthalmologists in a Large Administrative Claims Database

Yilin Feng¹,

Chun Chieh Lin²,

Ali G. Hamedani³

et al.

Abstract: Supplemental Digital Content is Available in the Text.

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2024

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Validity of Administrative Coding for Nonarteritic Ischemic Optic Neuropathy

Hamedani,

Kim,

Chaitanuwong

et al. 2024

Journal of Neuro-Ophthalmology

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Background: Administrative claims have been used to study the incidence and outcomes of nonarteritic ischemic optic neuropathy (NAION), but the validity of International Classification of Diseases (ICD)-10 codes for identifying NAION has not been examined. Methods: We identified patients at 3 academic centers who received ≥1 ICD-10 code for NAION in 2018. We abstracted the final diagnosis from clinical documentation and recorded the number of visits with an NAION diagnosis code. We calculated positive predictive value (PPV) for the overall sample and stratified by subspecialty and the number of diagnosis codes. For patients with ophthalmology or neuro-ophthalmology visit data, we recorded presenting symptoms, examination findings, and laboratory data and calculated PPV relative to case definitions of NAION that incorporated sudden onset of symptoms, optic disc edema, afferent pupillary defect, and other characteristics. Results: Among 161 patients, PPV for ≥1 ICD-10 code was 74.5% (95% CI: 67.2%–80.7%). PPV was similar when restricted to patients who had visited an ophthalmologist (75.8%, 95% CI: 68.4%–82.0%) but increased to 86.8% when restricted to those who had visited neuro-ophthalmologists (95% CI: 79.2%–91.9%). Of 113 patients with >1 ICD-10 code and complete examination data, 37 (32.7%) had documented sudden onset, optic disc swelling, and an afferent pupillary defect (95% CI: 24.7%–42.0%). Of the 76 patients who did not meet these criteria, 54 (71.0%) still received a final clinical diagnosis of NAION; for most (41/54, 75.9%), this discrepancy was due to lack of documented optic disc edema. Conclusions: The validity of ICD-10 codes for NAION in administrative claims data is high, particularly when combined with provider specialty.

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Validity of Administrative Coding for Nonarteritic Ischemic Optic Neuropathy

Hamedani,

Kim,

Chaitanuwong

et al. 2024

Journal of Neuro-Ophthalmology

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show abstract

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A Validated Method to Identify Neuro-Ophthalmologists in a Large Administrative Claims Database

Abstract: Supplemental Digital Content is Available in the Text.

Cited by 1 publication

References 9 publications

Validity of Administrative Coding for Nonarteritic Ischemic Optic Neuropathy

Validity of Administrative Coding for Nonarteritic Ischemic Optic Neuropathy

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