Unspecified falls among youth: predictors of coding specificity in the emergency department

Abstract

Deficiencies in both chart documentation and coding specificity contribute to the use of non-specific E-codes. More comprehensive triage coding, improved chart documentation, and alternative methods of data collection in the acute care setting are required to improve ED injury surveillance initiatives.

The role of alcohol in unintentional falls among young and middle-aged adults: a systematic review of epidemiological studies

“…The identification and recruitment of study cases from hospital ED and admission records may have introduced selection biases due to the unreliability of the coding of fall injury,22 23 and to referral patterns and access issues that result in some cases attending ED while others seek care from alternative providers or not at all 24 25. Moreover, trauma studies based only on admitted patients may be more likely to include intoxicated minor injury cases, due to the difficulty of initial clinical assessment among intoxicated patients which can result in biased estimates of association between alcohol and injury risk 25…”

“…ED records were used in two studies to identify BAC 13 15. These data are commonly incomplete,23 31 32 potentially resulting in missing exposure or confounder information.…”

“…The lack of primary analytical studies with a population focus is a major limitation identified in this review. A number of studies drew participants from specific emergency departments, hospitals or clinics, introducing a number of selection biases 22 23 42 43…”

Charges associated with pediatric head injuries: A five-year retrospective review of 41 pediatric hospitals in the US.

“…Previous research on the accuracy of E-codes in falls found that forty-six percent of the charts listing an E-code for unspecified falls could be assigned a more specific E-code based on the information documented in the patients’ charts. 26 As ICD-9 codes are diagnostic codes used for primarily for billing purposes instead of the clinical management of patients, the validity of database information is questionable, and its application is limited. Additionally, assigning accurate E-codes may be difficult, particularly in determining accidental and non-accidental injuries, based on medical records.…”