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\begin{document}

\title{Accuracy of ICD-10 Diagnosis Codes for Placenta Accreta Spectrum
Disorders}



\author[1]{Stephanie Leonard}%
\author[1]{Anjali Jotwani}%
\author[1]{Deirdre Lyell}%
\author[2]{Alexander Butwick}%
\author[1]{Wanjiru Rwigi}%
\affil[1]{Stanford University Department of Obstetrics and Gynecology}%
\affil[2]{Stanford University Department of Anesthesiology Perioperative and Pain Medicine}%


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  \date{May 19, 2024}


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\begin{abstract}
\textbf{Objective:} To evaluate the accuracy of ICD-10 codes for
placenta accreta spectrum (PAS). \textbf{Design:} Validation study.
\textbf{Setting:} Quaternary obstetric center in the U.S.
\textbf{Population:} Patients who had a delivery or dilation and
evacuation between October 2015 and March 2020. \textbf{Methods:} We
reviewed medical records of patients who were (1) assigned an ICD-10
code for PAS (O43.21-O43.23), (2) had a histopathologic diagnosis of
PAS, and/or (3) underwent a cesarean delivery with subsequent review of
placental pathology. \textbf{Main Outcome Measures:} Sensitivity,
specificity, positive predictive value, and negative predictive value of
the ICD-10 PAS code assignments. \textbf{Results:} Among 22,345
patients, 104 (0.46\%) had an ICD-10 code for PAS and 51 (0.23\%) had a
histopathologic diagnosis of PAS. ICD-10 codes for PAS had a sensitivity
of 88\% (95\% CI: 76-96\%), specificity of 97\% (95\% CI: 91-99\%),
positive predictive value of 43\% (95\% CI: 34-53\%), and negative
predictive value of 100\% (95\% CI: 96-100\%). The sensitivities of the
individual ICD-10 codes for placenta accreta, increta, and percreta were
72\% (95\% CI: 47-90\%), 47\% (95\% CI: 21-73\%), and 67\% (95\% CI:
41-87\%), respectively. Based on chart review, primary reasons for code
misassignment included code assigned at referral for PAS ultrasound
evaluation (28\%) and code assigned based on antenatal imaging alone
(27\%). \textbf{Conclusion:} The sensitivity, specificity, and negative
predictive value of ICD-10 codes for PAS were overall high, but the
positive predictive value was moderate. These findings suggest that
ICD-10 codes may be useful for research and surveillance of PAS, but
opportunities may exist to improve accuracy.%
\end{abstract}%



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\textbf{Hosted file}

\verb`PAS_ICD_Validation_100623.docx`  available at \url{https://authorea.com/users/672836/articles/671750-accuracy-of-icd-10-diagnosis-codes-for-placenta-accreta-spectrum-disorders}

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