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Awarded New Investigator/Doctoral Dissertation Grant

Injury Diagnosis Code Accuracy in Medicaid Claims Data

FOA Number: CE04-046 - Grants for New Investigator Training Awards
Project Period: 8/01/04–7/31/05
Application/Grant Number: 1-R49-CE000241-01
Principal Investigator: Huiyun Xiang MD, MPH, PhD
Children’s Research Institute
700 Children’s Drive
Columbus, OH 43205
Phone: 614-722-5961
Fax: 614-722-2448


This project will validate the childhood injury diagnosis codes in Medicaid emergency department (ED) claims data. Medicaid claims data are readily available for injury research and program evaluation due to mandatory submission of such data by all states to the Center for Medicare and Medicaid Services. However, little is known about the accuracy of the injury diagnosis codes in those data. The specific aims of this study are to 1) examine the quality of key demographic variables in Medicaid claims data, (2) investigate the accuracy and sensitivity of injury diagnosis codes to identify children's injuries, and 3) evaluate comparability of the NEISS and the ICD 9 CM injury diagnosis codes. A stratified sample from 21,554 injury cases captured by the NEISS in 2003 at the study site will result in 851 Medicaid injury cases. This study will link injury data captured by the NEISS with Medicaid claims data. The investigator will use standards in CDC’s Data Elements for Emergency Department Systems to examine the data quality of key demographic variables (e.g., date of birth and gender) in Medicaid claims data. Medical records review will investigate the accuracy and sensitivity of ICD 9 CM injury diagnosis codes. An innovative bridging scheme will evaluate the comparability of the NEISS injury diagnosis codes and ICD 9 CM injury diagnosis codes. This project is the first part of a multi-component research program developed by the applicant to investigate injuries among poor children and those with disabilities. If proved valid and reliable, funding will be sought next by the applicant to use Medicaid claims data to study the injury medical care costs among Medicaid children and the injury risk among children with mental health problems.