Volume 53 | Number 5 | October 2018

Abstract List

Garth H. Utter M.D., M.Sc., Ginger L. Cox R.H.I.T., C.C.S., Oluseun O. Atolagbe M.B.B.S., M.P.H., Pamela L. Owens Ph.D., Patrick S. Romano M.D., M.P.H.


To convert the Agency for Healthcare Research and Quality's () Quality Indicators (s) from International Classification of Diseases, 9th Revision, Clinical Modification (‐9‐) specifications to , 10th Revision, Clinical Modification and Procedure Classification System (‐10‐/) specifications.

Data Sources

ICD‐9‐CM and ICD‐10‐CM/PCS classifications, General Equivalence Maps (GEMs).

Study Design

We convened 77 clinicians and coders to evaluate ‐10‐/ codes mapped from ‐9‐ using automated s. We reviewed codes to develop “legacy” specifications resembling those in ‐9‐ and “enhanced” specifications addressing enhanced capabilities of ‐10‐/.

Data Collection/Extraction Methods

We tabulated the numbers of mapped codes, added nonmapped codes, and deleted mapped codes to achieve the specifications.

Principal Findings

Of 212 clinical concepts (sets of codes) that comprise the specifications, we either added nonmapped codes to or deleted mapped codes from 115 (54 percent). The legacy and enhanced specifications differed for 46 sets (22 percent), affecting 67 of the 101 s (66 percent). Occasionally, concepts that defied conversion required reformulation of indicators.


Converting the s to ‐10‐/ required a detailed, thorough process beyond automated mapping of codes. Differences between the legacy and enhanced versions of the s are frequently minor but sometimes substantive.