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Study examines reliability of clinical and pathological diagnoses of Barrett's esophagus
Date:5/14/2009

OAK BROOK, Ill. May 14, 2009 In a review of more than 2,000 patients coded for Barrett's esophagus, electronic diagnosis overestimated the prevalence of the disease according to researchers in California. They found that only 61.9 percent of patients assigned a billing diagnosis code for Barrett's esophagus actually had Barrett's esophagus after a manual record review. The study evaluated the accuracy of diagnostic codes for Barrett's esophagus by contrasting codes from electronic databases with diagnoses from a detailed medical record review. Researchers also evaluated the reproducibility of a pathologic diagnosis of Barrett's esophagus between two pathologists and between a single pathologist on two different occasions. The study appears in the May issue of GIE: Gastrointestinal Endoscopy, the monthly peer-reviewed scientific journal of the American Society for Gastrointestinal Endoscopy (ASGE).

Medical coding translates a patient's diagnosis [International Classification of Disease, 9th revision (ICD-9-CM) codes], pathology results [Systematized Nomenclature of Medicine (SNOMED) codes] and procedures [Current Procedural Terminology (CPT) codes] into universal medical code numbers that can be recorded in an electronic database. Diagnostic and procedure codes are used for a variety of reasons including insurance reimbursement, to track diseases and for statistical analysis. Payers require accurate reporting of diagnosis coding to explain why a service was provided to a patient.

Two reasons may explain the discrepancy between the electronic coding of Barrett's esophagus and the "final diagnosis" from pathology results. First, some physicians will report the diagnosis of Barrett's esophagus (ICD-9-CM code 530.85-Barrett's esophagus) based on visual appearance when the final pathologic diagnosis does not confirm Barrett's esophagus. This scenario can pertain in office and Ambulatory Surgery Center facilities where physicians are like
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Contact: Anne Brownsey
abrownsey@asge.org
630-570-5635
American Society for Gastrointestinal Endoscopy
Source:Eurekalert

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