{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T13:47:07Z","timestamp":1783604827458,"version":"3.55.0"},"reference-count":15,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:sec>\n            <jats:title>BACKGROUND<\/jats:title>\n            <jats:p>ICD codes are used to identify patients with appendicitis and to classify disease severity for reimbursement and research purposes. We sought to compare the accuracy of ICD-9 vs ICD-10 codes in classifying appendicitis as uncomplicated vs complicated (defined as perforated, necrotic, or abscess) compared with the clinical gold standard: surgeon characterization of the appendix in the operative report.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>STUDY DESIGN<\/jats:title>\n            <jats:p>This is a retrospective review of operative reports and discharge ICD-9\/10 codes for patients 18 years or older who underwent noninterval, nonincidental appendectomy from January 2012 to December 2019 at a tertiary referral center. Sensitivity, specificity, and positive predictive value were calculated for ICD-9\/10 codes to classify appendicitis as complicated when compared with surgeon description. Chi-square testing was used to compare agreement between ICD-9\/10 codes and surgeon description.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS<\/jats:title>\n            <jats:p>A total of 1,585 patients underwent appendectomy. ICD-9 codes had higher sensitivity than ICD-10 codes for complicated appendicitis (sensitivity 0.84 and 0.54, respectively) and a similar positive predictive value (0.77 and 0.76, respectively). Overall, 91% of ICD-9 codes agreed with surgical description of disease, but 84.4% of ICD-10 codes agreed with surgical description (p &lt; 0.01). Among cases classified as complicated by the surgeon, 84% (79\/94) had an accurate ICD-9 code for complicated disease, but only 53.8% (57\/106) of cases had an accurate ICD-10 code (p &lt; 0.01).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSIONS<\/jats:title>\n            <jats:p>Compared with ICD-9 codes, ICD-10 codes were less accurate in characterizing severity of appendicitis. The ICD-10 coding schema does not provide an accurate representation of disease severity. Until this system is improved, significant caution is needed for people who rely on these data for billing, quality improvement, and research purposes.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/xcs.0000000000000058","type":"journal-article","created":{"date-parts":[[2022,4,5]],"date-time":"2022-04-05T01:02:16Z","timestamp":1649120536000},"page":"377-383","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":20,"title":["Comparative Accuracy of ICD-9 vs ICD-10 Codes for Acute Appendicitis"],"prefix":"10.1097","volume":"234","author":[{"given":"Swetha","family":"Duraiswamy","sequence":"first","affiliation":[{"name":"From the Department of Surgery, Boston Medical Center and Boston University School of Medicine, Boston, MA (Duraiswamy, Sanchez, Tseng, Thurston Drake)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda","family":"Ignacio","sequence":"additional","affiliation":[{"name":"the Department of Biostatistics, Boston University School of Public Health, Boston, MA (Ignacio, Weinberg)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janice","family":"Weinberg","sequence":"additional","affiliation":[{"name":"the Department of Biostatistics, Boston University School of Public Health, Boston, MA (Ignacio, Weinberg)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabrina E","family":"Sanchez","sequence":"additional","affiliation":[{"name":"From the Department of Surgery, Boston Medical Center and Boston University School of Medicine, Boston, MA (Duraiswamy, Sanchez, Tseng, Thurston Drake)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David R","family":"Flum","sequence":"additional","affiliation":[{"name":"the Department of Surgery, University of Washington Medical Center, Seattle, WA (Flum)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael K","family":"Paasche-Orlow","sequence":"additional","affiliation":[{"name":"the Department of Medicine, Section of General Internal Medicine, Boston Medical Center, Boston, MA (Paasche-Orlow)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly M","family":"Kenzik","sequence":"additional","affiliation":[{"name":"the Institute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham, Birmingham, AL (Kenzik)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer F","family":"Tseng","sequence":"additional","affiliation":[{"name":"From the Department of Surgery, Boston Medical Center and Boston University School of Medicine, Boston, MA (Duraiswamy, Sanchez, Tseng, Thurston Drake)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederick Thurston","family":"Drake","sequence":"additional","affiliation":[{"name":"From the Department of Surgery, Boston Medical Center and Boston University School of Medicine, Boston, MA 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Surg"},{"key":"R8-20250821","doi-asserted-by":"crossref","first-page":"886","DOI":"10.1097\/01.sla.0000256391.05233.aa","article-title":"Disconnect between incidence of nonperforated and perforated appendicitis: implications for pathophysiology and management.","volume":"245","author":"Livingston","year":"2007","journal-title":"Ann Surg"},{"key":"R9-20250821","doi-asserted-by":"crossref","first-page":"839","DOI":"10.1097\/TA.0000000000002674","article-title":"Validation of the American Association for the Surgery of Trauma grading system for acute appendicitis severity.","volume":"88","author":"Mouch","year":"2020","journal-title":"J Trauma Acute Care Surg"},{"key":"R11-20250821","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1001\/jamasurg.2018.4282","article-title":"Nonoperative management of uncomplicated appendicitis among privately insured patients.","volume":"154","author":"Sceats","year":"2019","journal-title":"JAMA Surg"},{"key":"R12-20250821","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1016\/j.jss.2004.08.020","article-title":"Evaluating diagnostic accuracy in appendicitis using administrative data.","volume":"123","author":"Flum","year":"2005","journal-title":"J Surg Res"},{"key":"R13-20250821","doi-asserted-by":"crossref","first-page":"638","DOI":"10.1016\/j.jpedsurg.2014.11.001","article-title":"Correlating surgical and pathological diagnoses in pediatric appendicitis.","volume":"50","author":"Fallon","year":"2015","journal-title":"J Pediatr Surg"},{"key":"R14-20250821","doi-asserted-by":"crossref","first-page":"1021","DOI":"10.1001\/jamasurg.2018.2085","article-title":"Association of intraoperative findings with outcomes and resource use in children with complicated appendicitis.","volume":"153","author":"Anandalwar","year":"2018","journal-title":"JAMA Surg"},{"key":"R15-20250821","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1097\/TA.0000000000001274","article-title":"Increased anatomic severity predicts outcomes: validation of the American Association for the Surgery of Trauma\u2019s Emergency General Surgery score in appendicitis.","volume":"82","author":"Hernandez","year":"2017","journal-title":"J Trauma Acute Care Surg"},{"key":"R16-20250821","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1097\/01.JAA.0000544304.30954.40","article-title":"Complicated appendicitis and considerations for interval appendectomy.","volume":"31","author":"Perez","year":"2018","journal-title":"JAAPA"},{"key":"R17-20250821","doi-asserted-by":"crossref","first-page":"808","DOI":"10.1016\/j.surg.2020.10.035","article-title":"Where did the patients go? Changes in acute appendicitis presentation and severity of illness during the coronavirus disease 2019 pandemic: a retrospective cohort study.","volume":"169","author":"Neufeld","year":"2021","journal-title":"Surgery"}],"container-title":["Journal of the American College of Surgeons"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/XCS.0000000000000058","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T20:06:43Z","timestamp":1755806803000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/XCS.0000000000000058"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1,10]]},"references-count":15,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2022]]}},"URL":"https:\/\/doi.org\/10.1097\/xcs.0000000000000058","relation":{},"ISSN":["1072-7515"],"issn-type":[{"value":"1072-7515","type":"print"}],"subject":[],"published":{"date-parts":[[2022,1,10]]}}}