Table 2.
Estimated positive predictive values (PPVs) for opioid poisoning for 4 ICD-10-CM case definitions to capture data on heroin poisoning or other opioid poisoning, in an electronic health record case confirmation study in 12 emergency departments in Kentucky, October 2015–December 2016a
| Definition | No. of Visits | Estimated PPV, % (95% CI) |
|---|---|---|
| ED visits for treatment of heroin poisoning | ||
| Definition H-F (first-listed diagnosis) | 398 | 93.2 (90.0-96.3) |
| Definition H-S (secondary diagnosis) | 102 | 76.5 (68.1-84.8) |
| ED visits for treatment of poisoning involving opioids other than heroin | ||
| Definition OO-F (first-listed diagnosis) | 452 | 79.4 (75.7-83.1) |
| Definition OO-S (secondary diagnosis) | 103 | 67.0 (57.8-76.2) |
Abbreviations: ED, emergency department; ICD-10-CM, International Classification of Diseases, 10th Revision, Clinical Modification.18
a Medical records from 12 EDs in Kentucky dated from October 2015 through December 2016 were reviewed by emergency medicine physicians to assess the PPVs of 4 case definitions. A diagnosis of heroin poisoning was defined by the first 5 characters (excluding the period) of ICD-10-CM code T40.1X; a sixth character of 1 (unintentional poisoning), 2 (intentional self-harm), 3 (assault), or 4 (undetermined intent); and a seventh character of A (initial encounter) or D (subsequent encounter). A diagnosis of poisoning by other opioid (excluding heroin) was defined by an ICD-10-CM code with the first 5 characters in the range T40.0X, T40.2X, T40.3X, T40.4X, T40.60, or T40.69; sixth character from 1-4; and seventh character A or D.