Table 4.
Operational definition of the outcome of interest and performance measure of the ascertainment algorithm
| Outcome | ICD-9-CM code | Diagnosis description | Diagnosis position and claim type |
Performance of algorithm |
|
|---|---|---|---|---|---|
| Serious hypoglycemia | 251.0 | hypoglycemic coma | Any position of discharge diagnosis on ED claim or principal position on inpatient claim | PPV ~89%23 (ED claim); 78%24 (inpatient claim) | |
| 251.1 | other specific hypoglycemia | ||||
| 251.2 | hypoglycemia, unspecified | ||||
| 250.8X | diabetes with other specified manifestations | ||||
| Exclusionary diagnosis codes in the occurrences of 250.8X23-24 | |||||
| 259.8 | Other specified endocrine disorders | Secondary diabetic glycogenosis | Any position of discharge diagnosis on ED claim or principal position on inpatient claim | ||
| 272.7 | Mixed hyperlipidemia | Diabetic lipidosis | |||
| 681.XX | Cellulitis and abscess of finger and toe | Cellulitis | |||
| 682.XX | Other cellulitis and abscess | ||||
| 686.9 | Unspecified local infection of skin and subcutaneous tissue | ||||
| 707.1X | Ulcer of lower limbs, except decubitus ulcer | Ulcers of the lower extremity | |||
| 707.2X | Pressure ulcer stages | ||||
| 707.8 | Chronic ulcer of other specified sites | ||||
| 707.9 | Chronic ulcer of unspecified site | ||||
| 709.3 | Degenerative skin disorders | Necrobiosis lipoidica diabeticorum | |||
| 730.0X | Acute osteomyelitis | Osteomyelitis | |||
| 730.1X | Chronic osteomyelitis | ||||
| 730.2X | Unspecified osteomyelitis | ||||
| 731.8 | Other bone involvement in diseases classified elsewhere | ||||
ED: emergency department. ICD-9-CM: International Classification of Diseases, 9th Revision, Clinical Modification. PPV: positive predictive value.