Journal of Clinical Gastroenterology and Hepatology Open Access

  • ISSN: 2575-7733
  • Journal h-index: 5
  • Journal CiteScore: 0.63
  • Journal Impact Factor: 0.41
  • Average acceptance to publication time (5-7 days)
  • Average article processing time (30-45 days) Less than 5 volumes 30 days
    8 - 9 volumes 40 days
    10 and more volumes 45 days
Reach us +32 25889658


Validation of ICD-10 and CPT Codes to Identify Acute Esophageal Variceal Hemorrhage and Band Ligation among Patients with Liver Cirrhosis

Thomas Wang, Qian Bi, Marvin Ryou and Marwan S. Abougergi*

Background & Aim: Claims databases are used ever more widely in medical research. The building blocks of such databases are the ICD-10 CM codes, which are used to identify study patients, exposures and procedures. We aimed to determine the performance characteristics of the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10 CM) and the current procedural terminology (CPT) coding systems in identifying patients with acute esophageal variceal hemorrhage and esophageal variceal band ligation.

Methods: Both liver cirrhosis and acute gastrointestinal hemorrhage were ascertained using manual electronical medical record review. The study patients’ billing records were obtained and searched for ICD-10 CM code I85.xx for esophageal variceal hemorrhage and 06L34CZ, 06L38CZ and CPT code 43244 for esophageal variceal band ligation.

Results: 1,231 patient encounters were included. Alcohol was the most common etiology for liver cirrhosis (62.3%), and hematemesis (40.5%) was the most common patient presentation. A principal diagnosis ICD-10 CM code of I85.xx was associated with high sensitivity (84.8%), specificity (88.6%), positive (PPV, 92.9%) and negative (NPV, 77.0%) predictive values for presence of esophageal varices. For esophageal variceal band ligation, the ICD-10 CM had lower sensitivity than the CPT codes (51% versus 77%, respectively). However, both systems had similar specificity (99% and 99%), positive (97% and 96%), and negative (86% and 93%) predictive values in this setting.

Conclusion: ICD-10 CM diagnostic code I85.xx and procedure codes 06L34CZ and 06L38CZ as well as CPT code 43244 accurately identified patients with acute esophageal variceal hemorrhage and esophageal variceal band ligation, respectively.