ICD-9 and CPT Codes for Clinical Outcomes

Appendix

Appendix 1

ICD-9 and CPT codes for clinical outcomes

Cardiovascular-related endpoint (ICD-9 codes)
Cerebrovascular disease (Stroke) / 430-438
Acute myocardial infarction / 410
Cardiovascular death / Coronary artery disease [410-414] or cerebrovascular disease [430-438] on the day of death
Acute coronary syndromes (ICD-9 codes)
Acute myocardial infarction / 410
Unstable angina / 411.1
Microvascular complications (ICD-9 codes)
Retinopathy / 249.5, 250.5, 362.0, 362.1, 379.23
Nephropathy / 249.4, 250.4, 791.0
Neuropathy / 249.6, 250.6, 353.5, 356.9, 536.3, 713.5, 337.1, 357.2, 354, 355
Cardiovascular surgical procedures (ICD-9 procedure codes; CPT codes)
Coronary artery bypass graft / 36.10-36.19; 33510-33536
Percutaneous coronary intervention / 00.66, 36.01, 36.02, 36.05, 36.06, 36.07; 92982, 92984, 92980,92981

Appendix 2

Analysis of Baseline Characteristics Based on Dual-Goal Achievement in the 7-12 Months Following the Index Date

Characteristics / Dual-goal
(n=7,432) / Non–dual-goal
(n=9,397) / P value
Demographics
Age as of the index date, yearsA / 65.5 ± 10.2 / 61.5 ± 10.6 / < .001
Age groups, n (%)
18-44 / 160 (2.2) / 506 (5.4%)
45-54 / 798 (10.7) / 1,781 (19.0%)
55-64 / 2,933 (39.5) / 4,063 (43.2%)
65-69 / 992 (13.4) / 1,003 (10.7%)
70-74 / 1,018 (13.7) / 869 (9.3%)
75-79 / 874 (11.8) / 660 (7.0%)
80+ / 657 (8.8) / 515 (5.5%)
Male, n (%) / 7,243 (97.5) / 9,050 (96.3%) / .001
White, n (%) / 5,154 (69.4) / 6,115 (65.1%) / .001
Body mass index, kg/m2B / 31.6 ± 4.9 / 32. ± 5.4 / < .001
Index year, n (%) / .001
2004 / 1,237 (16.6) / 1,579 (16.8)
2005 / 1,625 (21.9) / 2,259 (24.0)
2006 / 1,230 (16.6) / 1,669 (17.8)
2007 / 1,297 (17.5) / 1,535 (16.3)
2008 / 1,340 (18.0) / 1,524 (16.2)
2009 / 703 (9.5) / 831 (8.8)
Baseline goal achievement, n (%)C
HbA1c<7% / 6,581 (88.6) / 5,391 (57.4) / .001
LDL-C<100 mg/dl / 5,982 (80.5) / 3,008 (32.0) / .001
Dual-goal Achievers / 3,900 (52.5) / 1,380 (14.7) / .001
Diabetes-related complications, n (%)
Microvascular
Retinopathy / 241 (3.2) / 517 (5.5) / < .001
Nephropathy / 189 (2.5) / 230 (2.5) / .693
Neuropathy / 799 (10.8) / 1,174 (12.5) / < .001
Macrovascular
Atherosclerosis, aneurysm, or embolism / 230 (3.1) / 213 (2.3) / .001
Peripheral vascular disease / 417 (5.6) / 465 (5.0) / .055
Cerebrovascular disease / 595 (8.0) / 626 (6.7) / .001
Coronary artery disease / 2,448 (32.9) / 2,259 (24.0) / < .001
Angina / 294 (4.0) / 349 (3.7) / .416
Myocardial infarction / 60 (0.8) / 79 (0.8) / .812
Other
InfectionD / 717 (9.7) / 901 (9.6) / .897
Ocular problemsE / 2,028 (27.3) / 2,377 (25.3) / .004
UlcerationF / 119 (1.6) / 134 (1.4) / .354
Ketoacidosis (without coma) and hyperosmolarity / 20 (0.3) / 38 (0.4) / .137
Hypoglycemia / 197 (2.7) / 278 (3.0) / .231
Comorbidities, n (%)
Cardiovascular diseaseG
Congestive heart failure / 489 (6.6) / 539 (5.7) / .023
Valvular heart disease / 158 (2.1) / 145 (1.5) / .005
Hypertension / 7,026 (94.5) / 8,781 (93.4) / .003
Other / 1,479 (19.9) / 1,528 (16.3) / < .001
Obesity / 2,086 (28.1) / 2,861 (30.5) / .001
Hyperlipidemia / 5,500 (74.0) / 6,732 (71.6) / .001
Depression / 2,713 (36.5) / 3,907 (41.6) / < .001
Renal disease / 701 (9.4) / 730 (7.8) / < .001
Tobacco use / 1,329 (17.9) / 1,962 (20.9) / < .001
Diabetic medications, n (%)
Oral anti-diabetic / 3,610 (48.6) / 5,365 (57.1) / < .001
Insulin / 480 (6.5) / 1,269 (13.5) / < .001
Anti-hypertensive / 5,257 (70.7) / 6,514 (69.3) / .047
Lipid lowering / 5,539 (74.5) / 6,467 (68.8) / < .001
Surgical Procedures, n (%)
Lower extremity amputation / 10 (0.1) / 24 (0.3) / .083
Coronary artery bypass graft / 28 (0.4) / 31 (0.3) / .610
Percutaneous coronary intervention / 68 (0.9) / 85 (0.9) / .944
Resource Utilization, n (%)
Outpatient visit / 7,337 (98.7) / 9,268 (98.6) / .595
Urgent care visit / 1,168 (15.7) / 1,669 (17.8) / < .001
Inpatient / 903 (12.2) / 1,221 (13.0) / .102
Emergency room / 400 (5.4) / 606 (6.5) / .004
Charlson comorbidity indexA / 0.3 ± 0.8 / 0.3 ± 0.7 / < .001
CCI = 0, n (%) / 5,955 (80.1) / 7,882 (83.9) / < .001
1 ≤ CCI <3, n (%) / 1,270 (17.1) / 1,316 (14.0) / < .001
CCI ≥ 3, n (%) / 207 (2.8) / 199 (2.1) / .005

Unless otherwise specified, all characteristics were measured in the 1-year period around the index date (i.e., six months before and six months after).

AData are means ± SD.

BEstimated using the height and weight information closest to the index date. For patients with no height and weight information, the average body mass index calculated from all other patients was used.

CCalculated using the area under the curve method for the first six months following the index date.

DIncludes skin, urinary tract, and kidney infections.

EIncludes glaucoma, macular edema, retinal edema, vitreous hemorrhage, and blindness.

F'Includes foot ulcer, bone changes, amputation, and other ulcerations.

GExcludes macrovascular complications.

Statistical significance is indicated with bolded text.

Abbreviations: CCI indicates Charlson comorbidity index; HbA1c, glycosylated hemoglobin A1c; LDL-C, low-density lipoprotein cholesterol.