Accuracy of diagnosis codes for patients with concurrent geographic atrophy and exudative age-related macular degeneration
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Description
INTRODUCTION
Age-related macular degeneration (AMD) is a leading cause of blindness. This disease progresses from the non-exudative/non-neovascular form to geographic atrophy (GA) or exudative AMD, which are regarded as distinct late AMD subtypes. However, histopathologic data confirms their coexistence. Despite this evidence, the International Classification of Diseases (ICD) diagnostic coding system offers no option for GA within the context of exudative AMD. Thus, the likelihood of underreporting GA coexisting with exudative AMD in the electronic medical record (EMR) is highly probable.
METHODS The study design was a cross-sectional retrospective chart review. EMRs of patients with exudative AMD who were seen at Associated Retinal Consultants in April 2021 were reviewed. These patients’ optical coherence tomography (OCT) scans were reviewed by two trained graders to evaluate for the presence of GA. Visual acuity, documentation of GA in the diagnosis codes, physical examination findings, and OCT interpretation were recorded.
RESULTS
A total of 656 patients were identified with exudative AMD, of which 377 (57%) had concurrent GA by OCT. This cohort had 102 males (27%) and 275 females (73%), with a mean age of 83.5 ± 9.0 (SD) years. An accurate ICD-10 code of GA was documented in 31 of the 377 patients (8%), while 346 of the 377 patients (92%) had evidence of GA on OCT but no diagnosis code for GA documented in the EMR. Although GA was not coded, 257 patients (68%) had GA documented accurately in the examination findings and 202 patients (54%) had GA documented accurately in the OCT interpretation.
CONCLUSIONS
A majority of patients with exudative AMD have evidence of concurrent GA on OCT. However, most do not have a GA diagnosis code listed in the EMR. Improving coding accuracy for GA will be important for identifying patients in large data registry studies and aid in selecting patients for new therapies.
Publication Date
5-2024
Disciplines
Ophthalmology
Recommended Citation
Clontz M, Park J, Chen X, Begaj T, Runner M, Wolfe J. Accuracy of diagnosis codes for patients with concurrent geographic atrophy and exudative age-related macular degeneration. Poster presented at: Oakland University William Beaumont School of Medicine Embark Capstone Colloquium; 2024 May; Rochester Hills, MI.
Comments
The Embark Capstone Colloquium at the Oakland University William Beaumont School of Medicine, Rochester Hills, MI, May, 2024.