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Validation of Diagnosis Codes to Identify Hospitalized COVID-19 Patients in Health Care Claims Data

    Basic Details

    Health plan claims may provide complete longitudinal data for timely, real-world population-level COVID-19 assessment. However, these data often lack laboratory results, the standard for COVID-19 diagnosis.

    We assessed the validity of International Classification of Disease, Tenth Revision, Clinical Modification (ICD-10-CM) diagnosis codes for identifying patients hospitalized with COVID-19 in U.S. claims databases, compared to linked laboratory results, among six FDA Sentinel System Data Partners (two large national insurers, four integrated delivery systems) from February 20 - October 17, 2020. We identified patients hospitalized with COVID-19 according to five ICD-10-CM diagnosis code-based algorithms, which included combinations of codes U07.1, B97.29, general coronavirus codes, and diagnosis codes for severe symptoms. We calculated the positive predictive value (PPV) and sensitivity of each algorithm relative to laboratory test results. We stratified results by data source type and across three time periods: February 20 - March 31 (Time A), April 1 - April 30 (Time B), May 1 - October 17 (Time C).


    Sheryl A. Kluberg, Laura Hou, Sarah K. Dutcher, Monisha Billings, Brian Kit, Sengwee Toh, Sascha Dublin, Kevin Haynes, Anne Marie Kline, Mahesh Maiyani, Pamala A. Pawloski, Eric S. Watson, Noelle M. Cocoros

    Corresponding Author

    Sheryl A. Kluberg; Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA