Published in:
01-06-2010 | Original Article
Ascertainment of Colonoscopy Indication Using Administrative Data
Published in: Digestive Diseases and Sciences | Issue 6/2010
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Background
Administrative procedure code data can estimate colonoscopy utilization; however, determining colonoscopy indication is more difficult as procedure codes do not inherently reflect the purpose (screening, surveillance, diagnosis) of the colonoscopy.
Aim
To improve the reported sensitivity (70%) and specificity (72%) of a published algorithm for identifying screening colonoscopies using Veterans Health Administration (VHA) administrative data.
Methods
We validated three algorithms for determining colonoscopy indication using medical records as the gold standard in a national sample of 650 patients. Algorithms used International Classification of Diseases, 9th Revision (ICD-9) and Current Procedural Terminology (CPT) codes. Medical records were manually abstracted using standardized protocols.
Results
The best algorithm had 83% sensitivity and 76% specificity for screening indication. Over 99% of colonoscopy CPT codes corresponded to a colonoscopy in the medical record.
Conclusions
VHA procedure codes are very accurate for colonoscopy utilization; however, algorithms to ascertain indication have only moderate accuracy.