Academic Commons

Articles

Validation of the V66.7 code for palliative care consultation in a single academic medical center

Hua, May; Li, Guohua; Clancy, Caitlin; Morrison, R. Sean; Wunsch, Hannah

Background: Use of administrative data to study the effectiveness of specialized palliative care is limited by the lack of a reliable method to identify patients receiving palliative care consultation. The International Classification of Diseases, Ninth Revision (ICD-9) code V66.7 has been used, but its validity for this purpose is unknown.
Objective: To examine the validity of the ICD-9 code V66.7 for identifying whether hospitalized patients received palliative care consultation.
Design: Retrospective cohort study.
Setting/Subjects: All patients age ≥ 18 years admitted to a single academic medical center between August 2013 and August 2015.
Measurements: Sensitivity and specificity of the V66.7 code for palliative care consultation for all patients and several a priori subgroups. The reference standard was the presence of a palliative care consultation note in the electronic medical record.
Results: Of 100,910 admissions, 1,999 received a palliative care consultation (2.0%) and 1,846 (1.8%) had usage of the V66.7 code. Sensitivity and specificity for the V66.7 code were 49.9% and 99.1% respectively. Sensitivity was considerably higher for certain subgroups, such as patients with dementia (76.3%) and metastatic cancer (66.3%); addition of age restrictions further improved sensitivity while maintaining high specificity. Specificity was substantially lower for patients who died during hospitalization (sensitivity 53.9%, specificity 75.1%).
Conclusions: In a single center, the ICD-9 code V66.7 had poor sensitivity and high specificity for identifying hospitalized patients who received a palliative care consultation. Appropriate use of this code for this purpose should take these characteristics into consideration.

Files

  • thumnail for Validation v66.7 single center JPM.docx Validation v66.7 single center JPM.docx application/vnd.openxmlformats-officedocument.wordprocessingml.document 380 KB Download File

Also Published In

Title
Journal of Palliative Medicine
DOI
https://doi.org/10.1089/jpm.2016.0363

More About This Work

Academic Units
Anesthesiology
Epidemiology
Published Here
June 3, 2019

Notes

This is a pre-print of an article published in Journal of Palliative Medicine, April 2017.

Academic Commons provides global access to research and scholarship produced at Columbia University, Barnard College, Teachers College, Union Theological Seminary and Jewish Theological Seminary. Academic Commons is managed by the Columbia University Libraries.