Injury Data Introduction Intermediate Injury Prevention August 23-26, 2011 – Billings, MT
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Transcript of Injury Data Introduction Intermediate Injury Prevention August 23-26, 2011 – Billings, MT
Injury Data IntroductionIntermediate Injury Prevention
August 23-26, 2011 – Billings, MT
Injury Data Introduction
Session Goal: • Review injury data concepts fr: Intro to IP Course• Understand classification system for injury
morbidity & mortality
Session Objectives:• Describe the uses of data• Define types of data• Identify common sources of injury data• Describe classification system for injury coding• Interpret listings of injury morbidity/mortality
codes
In Review…
What are the two types of data? (hint: words v. numbers)
How are data used in IP?
What are the sources of injury data?
Two Types of Data
Qualitative DataInterviews SurveysFocus groupsGives insight on development of your program/messages/materials
Quantitative DataRaw numbersCountsIdentify injury patternsSurveillanceObservationsRisk assessments
Use of Data in Injury Prevention
Understand trends patterns
Risk factorsCauses of injury
in a populationSet priorities for
preventionGuide/persuade
decision makers
Develop a program messaging & materials (design of float coats in AK; safety message for a targeted group)
Justify needs/build your case for funding (i.e., grants)
Evaluate your program
Common sources of injury data?
Local IHS severe injury surveillance system
Resources and patient management system
Medical records & death certificates
EMS & policeQuestionnaires
SurveysFocus groupsKey information
interviewsObservations
(seat belt surveys, home safety assessments)
In Review…
What are the agents of injury? (hint: Injury results from the transfer of energy)
What are the two main categories of injury?(hint: MVC and Domestic Violence are examples)
Agents of Injury
Mechanical: crushing injury in wringer washer, energy transferred during MV crash
Thermal: heat injuries –fire, hot water scalding
Chemical: battery acid spills, poisoning
Electrical: lightening Radiation: sunburn,
overexposure to x-ray Absence of oxygen:
drowning, suffocation, smoke inhalation, Carbon monoxide
Absence of heat: hypothermia, frostbite
Excess heat: heat stroke (hyperthermia)
Two Main Categories of Injury
Unintentional Drowning FallFireBurnMVCPoisoning
IntentionalSuicideSelf-HarmAssaultChild AbuseElder AbuseDomestic Violence
International Classification of Disease
Diagnosis CodesCause of Injury Codes
ICD-9 (Non-fatal)ICD-10 (Deaths)
Diagnosis Codes
Morbidity Required for Billing Numeric 800-999 Updated > annually Phase out: 2013
Mortality Alphanumeric S00-T98 Updated every Oct. Oct. 1, 2013 Morbidity
ICD-9 ICD-10
Diagnosis Codes - Examples
Fractures
Open Wound
Crushing
Burns
Poisoning
800-829
870-897
925-929
940-949
960-979
ICD-9 ICD-10
Injury to…
Head
Neck
Knee/Lower Leg
Mult. Body Parts
Burns & Corrosn
Frostbite
Poisoning
S00-S09
S10-S19
S80-S89
T00-T07
T20-T32
T33-T35
T36-T50
See Reference Handout
fx vault of skull; closed; no intercranial injury
less than 1 hr LOC
800.02
External Cause of Injury Codes
Morbidity Not required for billing Numeric preceded by “E” E800-E999 Allows for code for Place Updated > annually Phase out: 2013 State laws/coding rates
vary IHS hospital d/c rates: high IHS ED & CHS rates: low
Mortality Required for death certif Alphanumeric V01-Y98 Allows for code for Place Allows for code for
Activity Updated every Oct. Oct. 1, 2013 Morbidity
ICD-9 ICD-10
Diagnosis Codes - Examples
MV Traffic Accidents
Falls
Suicide/Self-Inflicted
Homicide (Assault)
E810-E819
E880-E888
E950-E959
E960-E969
ICD-9 ICD-10
Transport Accidents
Falls
Intentional Self-Harm
Assault
V01-V99
W00-W19
X60-X84
X85-Y09
See Reference Handout
Anatomy of an E-Code
X X X . YE
Injury Category Specificity
Anatomy of an E-Code
8 1 3 . 2E
MVC; collision w/other vehicle
Injured person was a motorcyclist
Analysis of E-Codes
E810.0E819.1E813.1E814.7E814.7E814.7E814.7E816.0E819.0E880.1E884.0E884.0E884.0E884.0E884.1E885.2E890.1E890.3E950.1E955.0E965.0E966.0
MVC E800-E825
Fall E880-E888
Fire E890-E899
Suicide E950-E959
Assault E960-E969
MVC invol. pedestrian
Fall; playground equip.
(E880-E888)Fall from: …escalator …ladder
…sidewalk curb …scaffolding…building/structure …diving…well …storm drain/manhole…playground …cliff…chair …wheelchair…bed …other furniture…commode …roller skates…skateboard …skis…snowboard …other/
unspecified
E-Code Example: Falls
Unspecified Fall
Fall from sidewalk curb
Fall from stairs
Fall from chairFall from commode
Analysis of E-Codes
E880.1E880.9E880.9E884.2E884.6 E888 E888 E888 E888 E888 E888 E888 E888 E888
Falls E800-E888
E-Codes Limitations
Records Not Always E-coded
Miscoding & Inconsistent Coding
Poor Chart Info = Nonspecific E-Code
Don’t Always Provide Desired Specificity
Must Stay Apprised of Updates
National Center for Health Statistics
Injury
E Coded on Death Certificate by Coroner
State Government
E Coded at Hospital
County Health Department
Fatality Hospitalization
WISQARS Data System(Web- Based)
External Cause of InjuryCoding References
American Academy of Professional Codershttp://www.aapc.com/
World Health Organizationhttp://www.who.int/classifications/icd/en/
CDC National Center for Health Statisticshttp://www.cdc.gov/nchs/icd.htm
CDC article on improving E-coding
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5701a1.htm
E-Code Exercise
Searchable ICD-9 code: http://icd9cm.chrisendres.com/index.php