Injury Data IntroductionIntermediate Injury Prevention

August 23-26, 2011 – Billings, MT

Injury Data Introduction

Session Goal: • Review injury data concepts fr: Intro to IP Course• Understand classification system for injury

morbidity & mortality

Session Objectives:• Describe the uses of data• Define types of data• Identify common sources of injury data• Describe classification system for injury coding• Interpret listings of injury morbidity/mortality

codes

In Review…

What are the two types of data? (hint: words v. numbers)

How are data used in IP?

What are the sources of injury data?

Two Types of Data

Qualitative DataInterviews SurveysFocus groupsGives insight on development of your program/messages/materials

Quantitative DataRaw numbersCountsIdentify injury patternsSurveillanceObservationsRisk assessments

Use of Data in Injury Prevention

Understand trends patterns

Risk factorsCauses of injury

in a populationSet priorities for

preventionGuide/persuade

decision makers

Develop a program messaging & materials (design of float coats in AK; safety message for a targeted group)

Justify needs/build your case for funding (i.e., grants)

Evaluate your program

Common sources of injury data?

Local IHS severe injury surveillance system

Resources and patient management system

Medical records & death certificates

EMS & policeQuestionnaires

SurveysFocus groupsKey information

interviewsObservations

(seat belt surveys, home safety assessments)

In Review…

What are the agents of injury? (hint: Injury results from the transfer of energy)

What are the two main categories of injury?(hint: MVC and Domestic Violence are examples)

Agents of Injury

Mechanical: crushing injury in wringer washer, energy transferred during MV crash

Thermal: heat injuries –fire, hot water scalding

Chemical: battery acid spills, poisoning

Electrical: lightening Radiation: sunburn,

overexposure to x-ray Absence of oxygen:

drowning, suffocation, smoke inhalation, Carbon monoxide

Absence of heat: hypothermia, frostbite

Excess heat: heat stroke (hyperthermia)

Two Main Categories of Injury

Unintentional Drowning FallFireBurnMVCPoisoning

IntentionalSuicideSelf-HarmAssaultChild AbuseElder AbuseDomestic Violence

International Classification of Disease

Diagnosis CodesCause of Injury Codes

ICD-9 (Non-fatal)ICD-10 (Deaths)

Diagnosis Codes

Morbidity Required for Billing Numeric 800-999 Updated > annually Phase out: 2013

Mortality Alphanumeric S00-T98 Updated every Oct. Oct. 1, 2013 Morbidity

ICD-9 ICD-10

Diagnosis Codes - Examples

Fractures

Open Wound

Crushing

Burns

Poisoning

800-829

870-897

925-929

940-949

960-979

ICD-9 ICD-10

Injury to…

Head

Neck

Knee/Lower Leg

Mult. Body Parts

Burns & Corrosn

Frostbite

Poisoning

S00-S09

S10-S19

S80-S89

T00-T07

T20-T32

T33-T35

T36-T50

See Reference Handout

fx vault of skull; closed; no intercranial injury

less than 1 hr LOC

800.02

External Cause of Injury Codes

Morbidity Not required for billing Numeric preceded by “E” E800-E999 Allows for code for Place Updated > annually Phase out: 2013 State laws/coding rates

vary IHS hospital d/c rates: high IHS ED & CHS rates: low

Mortality Required for death certif Alphanumeric V01-Y98 Allows for code for Place Allows for code for

Activity Updated every Oct. Oct. 1, 2013 Morbidity

ICD-9 ICD-10

Diagnosis Codes - Examples

MV Traffic Accidents

Falls

Suicide/Self-Inflicted

Homicide (Assault)

E810-E819

E880-E888

E950-E959

E960-E969

ICD-9 ICD-10

Transport Accidents

Falls

Intentional Self-Harm

Assault

V01-V99

W00-W19

X60-X84

X85-Y09

See Reference Handout

Anatomy of an E-Code

X X X . YE

Injury Category Specificity

Anatomy of an E-Code

8 1 3 . 2E

MVC; collision w/other vehicle

Injured person was a motorcyclist

Analysis of E-Codes

E810.0E819.1E813.1E814.7E814.7E814.7E814.7E816.0E819.0E880.1E884.0E884.0E884.0E884.0E884.1E885.2E890.1E890.3E950.1E955.0E965.0E966.0

MVC E800-E825

Fall E880-E888

Fire E890-E899

Suicide E950-E959

Assault E960-E969

MVC invol. pedestrian

Fall; playground equip.

(E880-E888)Fall from: …escalator …ladder

…sidewalk curb …scaffolding…building/structure …diving…well …storm drain/manhole…playground …cliff…chair …wheelchair…bed …other furniture…commode …roller skates…skateboard …skis…snowboard …other/

unspecified

E-Code Example: Falls

Unspecified Fall

Fall from sidewalk curb

Fall from stairs

Fall from chairFall from commode

Analysis of E-Codes

E880.1E880.9E880.9E884.2E884.6 E888 E888 E888 E888 E888 E888 E888 E888 E888

Falls E800-E888

E-Codes Limitations

Records Not Always E-coded

Miscoding & Inconsistent Coding

Poor Chart Info = Nonspecific E-Code

Don’t Always Provide Desired Specificity

Must Stay Apprised of Updates

National Center for Health Statistics

Injury

E Coded on Death Certificate by Coroner

State Government

E Coded at Hospital

County Health Department

Fatality Hospitalization

WISQARS Data System(Web- Based)

External Cause of InjuryCoding References

American Academy of Professional Codershttp://www.aapc.com/

World Health Organizationhttp://www.who.int/classifications/icd/en/

CDC National Center for Health Statisticshttp://www.cdc.gov/nchs/icd.htm

CDC article on improving E-coding

http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5701a1.htm

E-Code Exercise

Searchable ICD-9 code: http://icd9cm.chrisendres.com/index.php