Validation of the V66.7 Code for Palliative Care Consultation in a Single Academic Medical Center

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

Research output: Contribution to journalArticlepeer-review

115 Scopus citations

Abstract

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 of 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 identified subgroups. The reference standard was the presence of a palliative care consultation note in the electronic medical record. Results: Of 100,910 admissions, 1999 received a palliative care consultation (2.0%) and 1846 (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.

Original languageEnglish
Pages (from-to)372-377
Number of pages6
JournalJournal of Palliative Medicine
Volume20
Issue number4
DOIs
StatePublished - 1 Apr 2017
Externally publishedYes

Keywords

  • International Classification of Disease Codes
  • end-of-life care
  • palliative medicine
  • validation studies

Fingerprint

Dive into the research topics of 'Validation of the V66.7 Code for Palliative Care Consultation in a Single Academic Medical Center'. Together they form a unique fingerprint.

Cite this