![]() A comparability factor less than 100 would indicate that fewer cases were coded for a given disease or condition in ICD-10-CM than in ICD-9-CM, whereas a factor greater than 100 would suggest that more cases were identified in ICD-10-CM than in ICD-9-CM. A comparability factor of 100 would indicate that the same number of cases were coded to a given disease or condition in ICD-10-CM as in ICD-9-CM, meaning minimal discontinuity. For example, a healthcare organization tracking heart disease or other conditions would need a comparability ratio to fully understand its patient population and the impact of any clinical interventions following the implementation of ICD-10-CM/PCS. Comparability ratios are needed to be able to track and trend data longitudinally. 8 While the ICD-10-CM/PCS General Equivalence Mappings (GEMs) are useful for suggesting potential equivalent ICD-10-CM or ICD-10-PCS codes for ICD-9-CM codes, the GEMs do not provide comparability ratios, sometimes also called comparability factors. These data discontinuities occurred with cause-of-death statistics when ICD-10 was adopted for mortality reporting in 1999. The transition to ICD-10-CM/PCS is expected to result in longitudinal data discontinuities for disease and procedural reporting. To prevent errors in decision-making and reporting, all stakeholders relying on longitudinal data for measure reporting and other purposes should investigate the impact of the conversion on their data. These results indicate significant differences in comparability between ICD-9-CM and ICD-10-CM code assignment, including when the codes are used for external reporting such as the Joint Commission Core Measures. The Joint Commission Core Measure comparability factor results range from 27.15 for Acute Respiratory Failure to 130.16 for Acute Myocardial Infarction. The raw comparability factor results range from 16.216 for Nicotine dependence, unspecified, uncomplicated to 118.009 for Chronic obstructive pulmonary disease, unspecified. ![]() This study utilized 3,969 de-identified dually coded records to examine raw comparability ratios, as well as the comparability ratios between the Joint Commission Core Measures. Longitudinal data comparisons can only be reliable if they use comparability ratios or factors which have been calculated using records coded in both classification systems. The General Equivalence Maps (GEMs), while useful for suggesting potential maps do not provide guidance regarding the frequency of any matches. The transition from ICD-9-CM to ICD-10-CM/PCS is expected to result in longitudinal data discontinuities, as occurred with cause-of-death in 1999. ![]()
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