Diagnosis | Misclassification | Reasons |
---|---|---|
Lumbar Herniated Disc (n = 29) | False Positive (n = 13) |
Spinal Stenosis Case (n = 8) Severe Incontinence Diagnosis (n = 1) Cervical or Thoracic Spine Case (n = 1) Flatback Syndrome Case (n = 1) Spondylolisthesis Case (n = 1) Revision Discectomy Case (n = 1) |
False Negative (n = 16) |
Incorrectly Classified as Spinal Stenosis (n = 9) Procedure Billing Codes not included in Data (n = 4) Incorrectly Marked as Non-Primary Indication because of urinary incontinence diagnosis (n = 2) Incorrectly Marked as Non-Primary Indication because of cauda equina diagnosis (n = 1) | |
Lumbar Spinal Stenosis (n = 46) | False Positive (n = 16) |
Herniated Disc Case (n = 9) Cervical or Thoracic Spine Case (n = 4) Infection Present (n = 1) Flatback Syndrome Case (n = 1) Epidural Abscess Case (n = 1) |
False Negative (n = 30) |
Procedure Billing Codes not included in Data (n = 11) Incorrectly Classified as Herniated Disc (n = 8) CPT code (63046, 63267) not included in algorithm (n = 6) Incorrectly Marked as Non-Primary Indication because of collapsed vertebra diagnosis (n = 2) Incorrectly Marked as Non-Primary Indication because of fecal incontinence diagnosis (n = 1) Incorrectly Marked as Non-Primary Indication because of fracture diagnosis (n = 1) Incorrectly marked as Non-Primary Indication because of bladder dysfunction diagnosis (n = 1) | |
Knee Osteoarthritis (n = 11) | False Positive (n = 2) |
Procedure was actually to revise previous knee replacement (n = 1) Rheumatoid Arthritis Case (n = 1) |
False Negative (n = 9) |
Procedure Billing Codes not included in Data (n = 6) CPT code (27486, 27487) not included in algorithm (n = 2) Incorrectly Marked as Non-Primary Indication because of osteonecrosis diagnosis (n = 1) | |
Hip Osteoarthritis (n = 23) | False Positive (n = 2) |
Osteonecrosis Diagnosis (n = 1) Developmental Hip Dysplasia Case (n = 1) |
False Negative (n = 21) |
Incorrectly Marked as Non-Primary Indication because of osteonecrosis diagnosis (n = 12) Procedure Billing Codes not included in Data (n = 6) CPT code (27134) not included in algorithm (n = 1) Incorrectly Marked as Non-Primary Indication because of fracture diagnosis (n = 1) Incorrectly Marked as Non-Primary Indication because of neoplasm diagnosis (n = 1) |