<p>Validity of ICD-10-CM Codes Used to Identify Patients with Chronic Hepatitis B and C Virus Infection in Administrative Claims Data from the Taiwan National Health Insurance Outpatient Claims Dataset</p>

Abstract

Purpose: To validate the use of International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes to identify patients with chronic hepatitis B virus (HBV) and hepatitis C virus (HCV) infection in the Taiwan National Health Insurance (NHI) Outpatient Claims Dataset. Methods: We conducted a retrospective study using results of HBV surface antigen (HBsAg), HBV e antigen (HBeAg), and anti-HCV antibody tests in the NHI Lab & Exam Dataset from January 1 to March 31, 2018, as the reference standard to confirm HBV and HCV infection cases. We calculated sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) to assess the performance of HBV infection-specific ICD-10-CM codes (B180, B181, and B191) and HCV infection-specific ICD-10-CM codes (B182 and B192) recorded in the NHI Outpatient Claims Dataset to identify patients with HBV or HCV infection. Results: In total, 196,635 and 120,628 patients had analyzable results for HBsAg/HBeAg tests and anti-HCV tests, respectively. Moreover, 44,574 and 14,443 were confirmed to have HBV and HCV infection, respectively. The sensitivity, specificity, PPV, and NPV were, respectively, 46%, 83%, 45%, and 84% for HBV infection-specific ICD-10-CM codes and 47%, 99%, 81%, and 93% for HCV infection-specific ICD-10-CM codes. The sensitivity demonstrated great variation by region, clinical setting, and physician specialty. Conclusion: The HBV and HCV infection-specific ICD-10-CM codes recorded by physicians in Taiwan NHI outpatient claims data in 2018 had moderate sensitivity and high specificity for both HBV and HCV infection. The PPV was high for HCV ICD-10-CM codes, yet moderate for HBV ICD-10-CM codes.

Statins use and its impact in EGFR‐TKIs resistance to prolong the survival of lung cancer patients: A Cancer registry cohort study in Taiwan

“…The HWDS claim data, which are managed by the Taiwan MOHW, consist of all medical records of more than 99% Taiwanese residents 22 . The diagnostic accuracy of the major diseases such as stroke, cardiovascular, and cancers was confirmed in other studies 22‐24 . The database is linked to the cancer patient data from the TCR and patient mortality from the TDR 25 .…”

“…22 The diagnostic accuracy of the major diseases such as stroke, cardiovascular, and cancers was confirmed in other studies. [22][23][24] The database is linked to the cancer patient data from the TCR and patient mortality from the TDR. 25 This study was approved by the institutional review board committee at Taipei Medical University, and the data were anonymized before analysis.…”

The Use of Administrative Data to Investigate the Population Burden of Hepatic Encephalopathy

“…As described above, algorithms for identifying cirrhosis have been validated in multiple datasets by multiple authors [ 7 , 8 , 9 ]. Coding algorithms have also been used to successfully identify cohorts with alcohol liver disease [ 8 ], non-alcoholic fatty liver disease [ 14 , 36 ], hepatitis C virus infection [ 8 , 37 , 38 , 39 ], and—with slightly less success—chronic hepatitis B virus infection [ 8 , 38 , 39 ]. Using the US Medicare database, we identified a cohort of patients with cirrhosis whose risk of incident diagnoses of HE were influenced by etiology (particularly alcohol-related liver disease), the presence of portal hypertension, comorbidities, and polypharmacy (particularly benzodiazepines, opioids, and proton pump inhibitors) [ 40 ].…”

Existing Data Sources in Clinical Epidemiology: The Taiwan National Health Insurance Laboratory Databases

“…6 inTable 2, the unit recorded in unit variable is S/N; nevertheless, the unit recorded in reference value is COI. The percentage of this kind of incompatible problem was 12.6% in 2015 and decreased to 7.5% in 2019 25.…”