The team found “significant discrepancies” between the surgeon diagnosis and discharge codes. For 170 lumbar fusions over a two-year period, 59 percent of the primary ICD-9-CM diagnosis codes matched the surgeon’s diagnosis. There were 43 that involved well-accepted indications for trauma, tumor or infection and 123 that were for degenerative disc disease.
Among the 123 cases with DDD indications, the researchers found the ICD-9-CM diagnosis matched the surgeon diagnosis only 45 percent of the time, according to the report.
“The team found that characterizing the indications for this surgery based on ICD-9-CM codes extracted from administrative databases does not accurately reflect the surgeon’s indication. While such databases may accurately describe the national rates of lumbar fusion surgery, the lack of fidelity in the source codes limits their ability to accurately identify indications for surgery,” according to the report.
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