Index to Chiropractic Literature
Index to Chiropractic Literature
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Tuesday, February 24, 2026
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ID 28719
  Title Describing congruence between ICD-10 coding and medical record text in Veteran Health Administration chiropractic notes
URL https://doi.org/10.1016/j.jcm.2025.08.014
Journal J Chiropr Med. 2025 ;24(1-4):119-124
Author(s)
Subject(s)
Peer Review Yes
Publication Type Article
Abstract/Notes

Objective: The purpose of this study was to describe the congruence between International Classification of Diseases, 10th Ed (ICD-10) codes and documented text diagnoses from chiropractic notes in the Veterans Health Administration (VHA).  

Methods: This was a cross-sectional analysis of VHA national administrative data. We randomly sampled 1000 on-station VHA chiropractic visits occurring from October 1, 2017, and September 30, 2018 from patients with no such visits within the prior 12 months. ICD-10 and documented text diagnoses were extracted and mapped to 10 defined categories based on body region, presence of radiculopathy, nonspecific musculoskeletal conditions, and nonmusculoskeletal conditions. A rating system evaluated the congruence between ICD-10 and text diagnoses.

Results: Of the 978 identified and abstracted notes, ICD-10 and text diagnoses were perfectly congruent in 441 (45.1%). With cases of partial congruence, ICD-10 codes contained less detail/fewer conditions than text in 194 (19.8%) and contained more detail/more conditions than text in 178 (18.2%). Mixed findings were present in 101 cases (10.3%), with ICD-10 and text both containing diagnoses not found in the other. Lastly, there were 64 cases (6.5%) where the 2 groups had no degree of congruence.

Conclusion: VHA chiropractic diagnostic coding and text documentation shows considerable congruence with variability in diagnostic detail. This provides a foundation for further study that may ultimately improve the quality of these data for clinical, research, and administrative uses.

Author Keywords: Chiropractic; Veterans health; Electronic health record; Documentation

This abstract is reproduced with the permission of the publisher; full text is available by subscription. Online access only.

 
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