Quantifying Plastic and Reconstructive Surgery Engagement in the Evolution of ICD-10 Codes.

Abstract

International Classification of Diseases (ICD)-10 code specificity is important for detailed diagnostic documentation. Insufficient coding granularity in plastic surgery may hinder accurate clinical documentation, impacting education, research, and patient care. This study examines ICD-10 code modification efforts by plastic surgeons and plastic surgery organizations within the last decade, subsequently detailing the formal proposal process and highlighting potential areas where coding modifications may be explored. A retrospective review of all modification proposals presented to the ICD Coordination and Maintenance Committee from March 2013 to March 2023 was conducted. Plastic surgery-related proposals were identified and evaluated for successful implementation. These results were compared to those of other specialties using Fisher exact tests and 2-tailed t tests. A total of 472 unique proposals were identified and reviewed. Surgeons and/or surgical organizations contributed to 111 (23.5%) novel proposals, 41 (36.9%) of which were initiated by surgeons. Nine surgical specialties and 14 supporting organizations were represented. The success rate for all surgical-related proposals was 85.6%, with an average time to implementation of 24.7 months. Only 2 (1.8%) of all surgical-related proposals pertained to plastic surgery, both of which were successfully implemented. Though a few plastic surgeons have taken advantage of the ICD code revision process within the last decade, the high overall success rate for surgical-related proposals suggests that this seems to be a feasible method by which plastic surgeons and plastic surgery organizations can bring about useful coding changes that meaningfully impact clinical practice.