The validity of hospital diagnostic and procedure codes reflecting morbidity in preterm neonates born <32 weeks gestation

ObjectiveTo determine the validity of diagnostic hospital billing codes for complications of prematurity in neonates Study DesignRetrospective cohort data from discharge summaries and clinical notes (n = 160) were reviewed by trained, blinded abstractors for the presence of intraventricular hemorrhage (IVH) grades 3 or 4, periventricular leukomalacia (PVL), necrotizing enterocolitis (NEC), stage 3 or higher, retinopathy of prematurity (ROP), and surgery for NEC or ROP. Data were compared to diagnostic billing codes from the neonatal electronic health record.ResultsIVH, PVL, ROP and ROP surgery had strong positive predictive values (PPV > 75%) and excellent negative predictive values (NPV > 95%). The PPVs for NEC (66.7%) and NEC surgery (37.1%) were low.ConclusionDiagnostic hospital billing codes were observed to be a valid metric to evaluate preterm neonatal morbidities and surgeries except in the instance of more ambiguous diagnoses such as NEC and NEC surgery.

Automated summary

This study found that diagnostic hospital billing codes are a reliable metric to evaluate complications and surgeries in preterm neonates, except for more ambiguous diagnoses such as necrotizing enterocolitis and its surgery.