News: 28% of firearm assaults in ED miscoded as accidents, study finds

In a recent study published in JAMA Network Open, nearly one-third of intentional firearm injuries that resulted in emergency department (ED) admissions had been inaccurately coded as accidents in ICD-10-CM. The researchers collected medical record data from three different hospitals, reviewing 1,227 medical records for patients who presented to the ED with a firearm injury of any severity between October 1, 2015, and December 31, 2019, JustCoding reported.

The study determined that 837 (68.2%) of the reviewed cases were assaults or intentional physical attacked. Of those assaults, however, they found 234 (28%) had been instead coded as unintentional injuries in the hospital discharge data. Examples of applicable ICD-10-CM codes for firearm injuries include W33.01XA (accidental discharge of shotgun, initial encounter) and Y35.023A (legal intervention involving injury by handgun, suspect injured, initial encounter).

According to the researchers, firearm injury intent coding would most likely improve if hospital records used unambiguous and explicit intent-related language. They also said that more coding instructions linked to assault as opposed to ‘accident’ would help. Databases such as the Nationwide Emergency Department Sample may not include reliable counts of intent-specific firearm injuries, so it’s important that firearm data is reviewed with caution.

Editor’s note: To read JustCoding’s coverage of this story, click here. To read the JAMA study, click here.