{
  "abstract": "Introduction Information about causes of injury is key for injury prevention efforts. Historically, cause-of-injury coding in clinical practice has been incomplete due to the need for extra diagnosis codes in the International Classification of Diseases-Ninth Revision-Clinical Modification (ICD-9-CM) coding. The transition to ICD-10-CM and increased use of clinical support software for diagnosis coding is expected to improve completeness of cause-of-injury coding. This paper assesses the recording of external cause-of-injury codes specifically for those diagnoses where an additional code is still required.Methods We used electronic health record and claims data from 10 health systems from October 2015 to December 2021 to identify all inpatient and emergency encounters with a primary diagnosis of injury. The proportion of encounters that also included a valid external cause-of-injury code is presented.Results Most health systems had high rates of cause-of-injury coding: over 85% in emergency departments and over 75% in inpatient encounters with primary injury diagnoses. However, several sites had lower rates in both settings. State mandates were associated with consistently high external cause recording.Conclusions Completeness of cause-of-injury coding improved since the adoption of ICD-10-CM coding and increased slightly over the study period at most sites. However, significant variation remained, and completeness of cause-of-injury coding in any diagnosis data used for injury prevention planning should be empirically determined.",
  "authors": [
    {
      "affiliations": [
        "Kaiser Permanente Washington Health Research Institute, Seattle, Washington, USA"
      ],
      "name": "Christine C Stewart"
    },
    {
      "affiliations": [
        "Kaiser Permanente Washington Health Research Institute, Seattle, Washington, USA"
      ],
      "name": "Gregory Simon"
    },
    {
      "affiliations": [
        "Henry Ford Health Center for Health Services Research, Detroit, Michigan, USA"
      ],
      "name": "Brian K Ahmedani"
    },
    {
      "affiliations": [
        "Kaiser Permanente Colorado Institute for Health Research, Denver, Colorado, USA"
      ],
      "name": "Arne Beck"
    },
    {
      "affiliations": [
        "Kaiser Permanente Hawaii Center for Health Research, Honolulu, Hawaii, USA"
      ],
      "name": "Yihe G Daida"
    },
    {
      "affiliations": [
        "Kaiser Permanente Northwest Center for Health Research, Portland, Oregon, USA"
      ],
      "name": "Frances L Lynch"
    },
    {
      "affiliations": [
        "Kaiser Permanente Georgia Center for Health Research, Atlanta, Georgia, USA",
        "Georgia State University, Atlanta, Georgia, USA"
      ],
      "name": "Ashli A Owen-Smith"
    },
    {
      "affiliations": [
        "Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California, USA"
      ],
      "name": "Sonya L Negriff"
    },
    {
      "affiliations": [
        "HealthPartners Institute, Bloomington, Minnesota, USA"
      ],
      "name": "Rebecca Rossom"
    },
    {
      "affiliations": [
        "Kaiser Permanente Division of Research, Oakland, California, USA"
      ],
      "name": "Stacy A Sterling"
    },
    {
      "affiliations": [
        "Department of Population Medicine, Harvard Medical School, Boston, Massachusetts, USA"
      ],
      "name": "Christine Y Lu"
    },
    {
      "affiliations": [
        "National Institute of Mental Health, Bethesda, Maryland, USA"
      ],
      "name": "Michael Schoenbaum"
    }
  ],
  "title": "Variation in completeness of coding external cause of injuries under ICD-10-CM",
  "uid": "9de9b850-10eb-552f-8692-b3e1f4b7fc51"
}