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Implementer report: ICD-10 code F44.5 review for functional seizure disorder.

Ali SF, Bornovski Y, Gopaul M, Galluzzo D, Goulet J, Argraves S, Jackson-Shaheed E, Cheung KH, Brandt CA, Altalib HH. Implementer report: ICD-10 code F44.5 review for functional seizure disorder. BMJ health & care informatics. 2023 Sep 1; 30(1).

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Abstract:

OBJECTIVE: The study aimed to measure the validity of International Classification of Diseases, 10th Edition (ICD-10) code F44.5 for functional seizure disorder (FSD) in the Veterans Affairs Connecticut Healthcare System electronic health record (VA EHR). METHODS: The study used an informatics search tool, a natural language processing algorithm and a chart review to validate FSD coding. RESULTS: The positive predictive value (PPV) for code F44.5 was calculated to be 44%. DISCUSSION: ICD-10 introduced a specific code for FSD to improve coding validity. However, results revealed a meager (44%) PPV for code F44.5. Evaluation of the low diagnostic precision of FSD identified inconsistencies in the ICD-10 and VA EHR systems. CONCLUSION: Information system improvements may increase the precision of diagnostic coding by clinicians. Specifically, the EHR problem list should include commonly used diagnostic codes and an appropriately curated ICD-10 term list for ''seizure disorder,'' and a single ICD code for FSD should be classified under neurology and psychiatry.




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