January 2013

Accuracy of International Classification of Diseases, Ninth Revision, Clinical Modification Billing Codes for Common Ophthalmic Conditions

Author Affiliations

Author Affiliations: Department of Ophthalmology and Visual Sciences, Duke University, Durham, North Carolina (Dr Muir); Department of Ophthalmology and Visual Sciences, William Beaumont Hospital, Royal Oak (Dr Gupta), and Department of Ophthalmology and Visual Sciences, Kellogg Eye Center, University of Michigan, Ann Arbor (Dr Stein); and Mercer University School of Medicine, Macon, Georgia (Ms Gill).

JAMA Ophthalmol. 2013;131(1):119-120. doi:10.1001/jamaophthalmol.2013.577

An increasing number of analyses use administrative claims data to study the epidemiology, risk factors, and resource consumption associated with patients with ocular diseases. These sources of voluminous data allow researchers to study common and uncommon conditions and assess care delivered by different health care providers in various communities. Because claims data are collected primarily for billing, not research purposes, a concern is whether the diagnoses listed in the billing records reflect the actual conditions described in the medical record.1 If claims data are found to inaccurately reflect patients' conditions, the usefulness of these data for research would be limited. The accuracy of claims data has been examined for selected eye diseases but not for many common ophthalmic conditions.24 We examine the accuracy of claims data for 5 such conditions.

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