CPT Hierarchy errors - lost children in 2023 and changed domains

Thanks for the great updates, Vocabulary team. To update your evidence base, so to speak, I wanted to note that we have used these in studies with some frequency. Specifically, there are 2+1 pieces of information the terms encode beyond the existence and setting of the encounter:

  • Presence of an E/M code indicates that a clinician actually interacted with the patient at the visit; this bit of metadata changes interpretation of things like the accuracy of condition_occurrence records and other facts reflective of clinical decision making.

  • The final digit indicates the “complexity” of the visit, a CPT-ish term for how sick the patient was, allowing the study to distinguish coarsely between complications and routine follow-up.

  • (As an added bonus, the critical care codes such as 9947x and 9929x are in administrative datasets often the only way to ascertain that a patient was receiving ICU-level care. As you might guess, this has been a topic of particular relevance in studying COVID-19.)

I know I’ve encountered these practices outside PEDSnet in EHR-oriented networks like PCORnet and NIH-RECOVER. I’d be curious to hear whether anyone else does something similar.


Regards,
Charles Bailey

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