ME TH O D S Clause Samples

ME TH O D S. In a US population-based, retrospective cohort study, we matched TB-related Systematized Nomenclature of Medicine–Clinical Terms (SNOMED CT) EHR codes and International Statistical Classifi- cation of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) claims codes. Furthermore, LTBI was identified using a published ICD-based algorithm and all LTBI- and TB-related SNOMED CT codes. R ESU LTS: Of people with the 10 most frequent TB- related claim codes, 50% did not have an exact-matched EHR code. Positive tuberculin skin test was the most frequent unmatched EHR code and people with the 10 most frequent TB EHR codes, 40% did not have an exact-matched claim code. The most frequent un- matched claim code was TB screening encounter. EHR codes for LTBI matched to claims codes for TB testing; pulmonary TB; and nonspecific, positive or adverse tuberculin reaction. CO N C L U S I O N : TB-related EHR codes and claims diagnostic codes often disagree, and people with claims codes for LTBI have unexpected EHR codes, indicating the need to reconcile these coding systems. KEY W O R D S : TB; latent tuberculosis; insurance; health; claims TUBERCULOSIS (TB) IS AN AIRBORNE infectious disease caused by the bacterium Mycobacterium tuberculosis. Signs and symptoms of active pulmo- nary TB infection can include chronic cough, chest pain, fatigue, fever, weight loss, and others.1 Latent tuberculosis infection (LTBI) is a state of persistent immune response to stimulation by M. tuberculosis antigens without active TB. An estimated 5% of people in the United States have LTBI,2 whereas active TB has been estimated at 2.8 cases per 100 000 persons.3 Untreated, 5–10% of those with newly detected M. tuberculosis infection will experience active TB (caused by the bacterium’s reactivation) during the person’s lifetime.4 Although LTBI treat- ment is effective in preventing TB reactivation,5 the majority of US residents with LTBI are untreated6 for multiple reasons.7 Insurance claims data have been used to estimate the frequency of LTBI- and TB-related diagnosis.8 However, the clinical accuracy of these estimates might be decreased because of coding practices favoring conditions with the highest reimbursement.9 Because ICD-10-CM codes for LTBI were not used before release of the 2020 International Statistical Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM),10 Stockbridge et al.11 published a claims-based algorithm for identifying LTBI cases. Alternative...