We further analyzed the CAUTI ICD-10-CM cases to determine why they did not meet NHSN criteria. This adjustment led to a sensitivity of 2.4% (95% CI, 0.4%–12.6%) and positive predictive value of 2.2% (95% CI, 0.4%–11.3%) ( Table 1).Ī The sensitivity of the ICD-10-CM code metric to identify CAUTI was 2.4% (95% CI, 0.4% to 12.6%). When the POA cases were eliminated using the NHSN criteria, 41 cases of ICD-10 CAUTI remained. The sensitivity of the ICD-10-CM code metric to identify CAUTI was 1.7% (95% CI, 0.3%–9.1%) and the positive predictive value was 2.2% (95% CI, 0.4%–11.3%). Of these 58 ICD-10-CM–coded cases, only 1 case (1.7%) was detected via NHSN criteria all discordant cases were reviewed to confirm that they did not meet NHSN criteria. For the same period, there were 58 cases of CAUTI according to the ICD-10-CM metric. We identified 46 CAUTI cases via active surveillance using the NHSN criteria. 9 Infection events identified by ICD-10-CM were subsequently characterized as HAIs by applying the NHSN date criteria to more directly compare the 2 metrics. CAUTI was considered an HAI if the NHSN site-specific infection criterion occurred on or after calendar day 3 of admission to an inpatient location (where the day of admission was calendar day 1). Using NHSN as the gold standard, the sensitivity and positive predictive value of the ICD-10-CM code metric were calculated.ĬAUTI was considered present on admission (POA) if the NHSN urinary infection criterion occurred during the following period: the day of admission to an inpatient location (calendar day 1), the 2 days before admission, or the calendar day after admission (calendar day 2). Cases detected by either method were compared. Data from NHSN surveillance were identified for the same period. The purpose of this study was to compare CAUTI data abstracted via ICD-10-CM to NHSN surveillance data to determine the utility of the ICD-10 code as a surrogate for the NHSN CAUTI metric.Īll patients medical records with the ICD-10-CM code related to CAUTI (T83.51XA, infection and inflammatory reaction due to indwelling urinary catheter, initial encounter) were retrieved via the Vizient (formerly University Healthcare Consortium) database at the University of Iowa Hospitals and Clinics for the period October 1, 2015, through September 30, 2016. Reference Cass, Kelly, Probst, Addy and Mckeown 3 – Reference van Mourik, van Duijn, Moons, Bonten and Lee 7 ICD-10-CM was implemented on October 1, 2015, 8 and to date, no study has evaluated it for the detection of CAUTI. Several studies evaluating the surveillance CAUTI using administrative codes from ICD-9-CM ( International Classification of Diseases, 9th Revision, Clinical Modification, code 996.64) revealed that the ICD-9 code performed poorly. Reference Horan, Andrus and Dudeck 2 However, NHSN surveillance typically requires utilizing trained infection preventionists to perform surveillance that is relatively labor intensive. Reference Klevens, Edwards and Richards 1 The National Healthcare Safety Network (NHSN) methodology for detecting CAUTI employs active surveillance with standardized definitions applied by infection preventionists and is currently considered the gold standard for surveillance. To the Editor-Catheter-associated urinary tract infections (CAUTIs) are the most common healthcare-associated infection (HAI), accounting for one-third of infections acquired in hospitals in the United States.

Icd 10 code for uti