ALTERNATE FLU DATA SOURCES, Study notes of Medical Sciences

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ALTERNATE FLU DATA SOURCES

By Johnathan Ledbetter, MPH

Outline

■ ICD-9 to ICD-10 conversion experience

■ Flu Near You

ICD-9 TO ICD- 10

CONVERSION

EXPERIENCE

Background

■ Received requests on what ICD-10 codes should be used

to capture influenza-like illness (ILI) data

■ No list of ICD-10 ILI codes existed

■ Need to research ICD-10 codes to provide a

recommended list of codes that would capture ILI data

Recommended ICD-10 Code List to

capture ILI Data

■ Narrowed the list of ICD-10 codes

• Influenza codes ■ J09, J10, and J
• Combination of codes that meet ILINet ILI case definition ■ R50.9- Fever, unspecified ■ J06.0- Acute laryngopharyngitis ■ J02.9- Acute pharyngitis ■ R05- Cough ■ Emailed list to health clinic systems ILI ICD-10 diagnoses codes (each of these diagnoses count as 1 ILI) J10.00 Influenza due to other identified influenza virus with unspecified type of pneumonia J10.01 Influenza due to other identified influenza virus with the same other identified influenza virus pneumonia J10.08 Influenza due to other identified influenza virus with other specified pneumonia J10.1 Influenza due to other identified influenza virus with other respiratory manifestations J10.2 Influenza due to other identified influenza virus with gastrointestinal manifestations J10.81 Influenza due to other identified influenza virus with encephalopathy J10.82 Influenza due to other identified influenza virus with myocarditis J10.83 Influenza due to other identified influenza virus with otitis media J10.89 Influenza due to other identified influenza virus with other manifestations J11.00 Influenza due to unidentified influenza virus with unspecified type of pneumonia J11.08 Influenza due to unidentified influenza virus with specified pneumonia J11.1 Influenza due to unidentified influenza virus with other respiratory manifestations J11.2 Influenza due to unidentified influenza virus with gastrointestinal manifestations J11.81 Influenza due to unidentified influenza virus with encephalopathy J11.82 Influenza due to unidentified influenza virus with myocarditis J11.83 Influenza due to unidentified influenza virus with otitis media J11.89 Influenza due to unidentified influenza virus with other manifestations J09.X1 Influenza due to identified novel influenza A virus with pneumonia J09.X2 Influenza due to identified novel influenza A virus with other respiratory manifestations J09.X3 Influenza due to identified novel influenza A virus with gastrointestinal manifestations J09.X9 Influenza due to identified novel influenza A virus with other manifestations ILI ICD-10 diagnosis ‘symptom’ codes ( patient must have a diagnosis in group A and group B to = 1 ILI) GROUP A GROUP B R50.9 Fever, unspecified J02.9 Acute pharyngitis J06.0 Acute laryngopharyngitis R05 Cough

Lessons Learned from ICD-9 to

ICD-10 Conversion

■ Not all health systems use the same codes to identify ILI

• Needed some standardization ■ Acceptable to go back to the basics and rethink the process
• Take into account the ILINet ILI Case Definition
• Question if the ICD codes are capturing just ILI cases

Post ICD Code Conversion Discussion Questions ■ What do you think about the recommended ILI ICD-10 code list that has been developed?

• Do you feel that this is a comprehensive list that would accurately capture ILI or influenza cases? or
• Would there be any other conditions or combination of conditions that could possibly be added to the list? ■ How could you use this information to improve influenza surveillance in your jurisdiction?

Post ICD Code Conversion Discussion Questions ■ Do you know of any healthcare providers that participate in your influenza surveillance program that pull ILI or influenza data using ICD-10 codes from their electronic health record system?

• If yes ■ How many providers pull ILI or influenza data using ICD- 10 codes? ■ Do you know what ICD-10 codes or combination of ICD- 10 codes are being used to pull ILI or influenza data? - What are the ICD-10 codes or combination of ICD-10 codes being used?

FLU NEAR YOU (FNY)

Initial Flu Near You (FNY) Discussion Questions

■ Have you heard of FNY before?

• How did you hear about FNY?

Reporting of Symptoms

Map of Influenza-like Illness/Flu-like Symptoms Generated by Flu Near You

Post Flu Near You (FNY) Discussion Questions ■ Could FNY data be used to complement other flu surveillance systems data that is collected in your jurisdiction?

• Why or why not would you want to use FNY data?
• How could FNY data be used to complement other flu surveillance systems data that is already collected? ■ Would you be willing to incorporate any FNY data into your weekly influenza surveillance report, if you have a weekly flu surveillance report?
• How would you incorporate FNY data into your weekly flu surveillance report?