Friday, September 15, 2017

Questions about CIHI Discharge Abstract Database Coding

Question:
I was reviewing the 2015-2016 Status variables (ST_AT_1 through _20) on the clinical file, checking frequencies from before and after recoding those variables. I discovered that there were a large number of status codes which were missed by my recode syntax. I’ve looked at the online Canadian Coding Standards for ICD-10-CA and CCI (https://secure.cihi.ca/estore/productFamily.htm?pf=PFC2785&lang=en&media=0), the DAD abstracting manual (and for that matter, all of the other documentation files received with DAD), and haven’t been able to find a list of the possible field contents.

Is there a complete list of status attribute codes (I hope that I’ve not simply missed it)?

  • I’m missing meanings for codes: D1,  DX, PA, PB, PC, RA, RB, RC, and UN.
  • I have meanings for codes: 0, B, C, CR, D, DP, DS, E, I , M1, M3, M4, N, N2, N3, N4, N5, N6, P, Q, R, S, S2, TM, U, UR, V, and Z. (e.g., U – Initial consultation)
  • Are there still more status attribute codes that I haven’t encountered yet?
While looking for the intervention status attribute codes, could you find a list of intervention location attribute codes (LC_AT_1 through LC_AT_20) on the clinical file (or let me know where I should have found them)?

I’m not sure where to find explanations of codes FE, FY, JU, LY, ML, MR, PI, RY, SC, and UN.

Answer:
A CCI status code list that was provided by CIHI.  They have indicated it was pulled from Appendix C of the v2015 CCI folio product.

The Folios are essentially electronic, interactive versions of the Manuals so the information contained in them should be the same. Unfortunately we cannot provide the client with a copy of the CCI Folio as it’s a paid product and there are licencing agreements etc. Hospital medical record departments may have a copy they can borrow.

Follow-Up Question:
Would it be possible to put a copy of the Word document that you received from CIHI in the documentation folder for the DAD? It could (should) be annotated to indicate that:

  • the Status list corresponds to variables ST_AT_1, ST_AT_2, …, ST_AT_20 in the DAD excerpt files
  • the Location list corresponds to variables LC_AT_1, LC_AT_2, …, LC_AT_20 in the DAD excerpt files
  • the Extent list does not correspond to any variables in the DAD excerpt files
Follow-Up Answer:
I’ve looked into this further and the ICD-10-CA/CCI has four volumes in total:
  • Volume 1—International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Canada (ICD-10-CA) - Tabular List
  • Volume 2—International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Canada (ICD-10-CA) - Alphabetical Index
  • Volume 3—Canadian Classification of Health Interventions (CCI) - Tabular List
  • Volume 4—Canadian Classification of Health Interventions (CCI) – Alphabetical Index
Typically, for the DLI data cuts, we only include the Tabular lists (Volumes 1 & 3). As to why we only release the Tabular lists, I can’t say -  only that this is what was being done since I’ve been with the team.

Appendix C is provided in Volume 4, as well as appearing in the electronic Folio mentioned earlier, which is why it didn’t turn up in your search.

I just received volume 2 and 4 of the CCI/ICD documentation. They have been placed in the CIHI safe located here:  /MAD_CIHI_ICIS_DAM/Root/discharge-abstract-database-2015-16/Other_documents/ICD10CA CCI v2015/EN/