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Table 2 Positive predictive values of health care claims-based algorithms for identifying patients with HIV, Kaiser Permanente Washington (2010–2020), N = 272 women

From: Validation of human immunodeficiency virus diagnosis codes among women enrollees of a U.S. health plan

Algorithm description

Number of women meeting algorithm criteria (N)

Number of women with confirmed HIV as of the date the algorithm criteria were met (n)

Positive

predictive value

([n/N]*100)

(95% CI)

1. Number of days with an HIV diagnosis code

   

 a) ≥ 1 day with an HIV diagnosis code

272

219

80.5 (75.4–84.8)

 b) ≥ 2 days with an HIV diagnosis code

230

216

93.9 (90.0-96.3)

 c) ≥ 3 days with an HIV diagnosis code

219

213

97.2 (94.2–98.7)

2. ICD-9-CM erab,c

   

 a) ≥ 1 day with an HIV diagnosis code during 1/1/2010-9/30/2015 (ICD-9-CM era)

139

108

77.7 (70.1–83.8)

 b) ≥ 1 day with an HIV diagnosis code during 1/1/2010-12/31/2012 (earlier ICD-9-CM era)

106

83

78.3 (69.5–85.1)

 c) ≥ 1 day with an HIV diagnosis code during 1/1/2013-9/30/2015 (later ICD-9-CM era)

33

25

75.7 (59.0-87.2)

3. ICD-10-CM erab,d

   

 a) ≥ 1 day with an HIV diagnosis code during 10/1/2015-12/31/2020 (ICD-10-CM era)

133

110

82.7 (75.4–88.2)

 b) ≥ 1 day with an HIV diagnosis code during 10/1/2015-12/31/2017 (earlier ICD-10-CM era)

38

27

71.1 (55.2–83.0)

 c) ≥ 1 day with an HIV diagnosis code during 1/1/2018-12/31/2020 (later ICD-10-CM era)

95

83

87.4 (79.2–92.6)

4. Individual ICD-9-CM HIV diagnosis codesb

   

 a) ≥ 1 day with ICD-9-CM HIV diagnosis code, 042 (“HIV disease”)

110

91

82.7 (74.6–88.7)

 b) ≥ 1 day with ICD-9-CM HIV diagnosis code, V08 (“Asymptomatic HIV infection status”)

98

82

83.7 (75.1–89.7)

 c) ≥ 1 day with an ICD-9-CM HIV diagnosis code, 079.53 (“Infection, conditions classified elsewhere & unspecified; HIV, type 2”)

2

2

100.0 (34.2–100.0)

 d) ≥ 1 day with ICD-9-CM diagnosis code 795.71 (“Nonspecific serological evidence of HIV”)

5

2

40.0 (11.8–76.9)

5. Individual ICD-10-CM HIV diagnosis codesb

   

 a) ≥ 1 day with ICD-10-CM diagnosis code B20 (“HIV disease”)

119

104

87.4 (80.2–92.2)

 b) ≥ 1 day with ICD-10-CM diagnosis code Z21 (“Asymptomatic HIV infection status; HIV positive NOS”)

100

92

92.0 (85.0-95.9)

 c) ≥ 1 day with ICD-10-CM diagnosis code B97.35 (“HIV, type 2 as the cause of diseases classified elsewhere”)

0

0

N/A

 d) ≥ 1 day with ICD-10-CM diagnosis code O98.711-O98.73 (“HIV disease complicating pregnancy, childbirth and the puerperium”)

10

10

100.0 (72.2–100.0)

6. HIV diagnosis codes and CD4 procedure codesa

   

 a) ≥ 1 day with an HIV diagnosis code & ≥1 day with a CD4 procedure code on or after the day of the first HIV code.

218

205

94.0 (90.1–96.5)

  1. HIV: human immunodeficiency virus; CI: confidence interval; ICD-9-CM: International Classification of Diseases Ninth Revision, Clinical Modification; ICD-10-CM: International Classification of Diseases Tenth Revision, Clinical Modification
  2. aCD4 procedure codes used were Current Procedural Terminology (CPT) 86,360 (“T cells; absolute CD4 and CD8 count, including ratio”) and 86,361 (“T cells; absolute CD4 count”)
  3. bEach row includes only those women whose first HIV diagnosis code during cohort follow-up occurred on or after the start of the time period examined. For individual ICD-9-CM codes (item #4) the time period examined was 1/1/2010-9/30/2015, and for individual ICD-10-CM codes (item #5) it was 10/1/2015-12/31/2020
  4. cThe ICD-9-CM era corresponds to time during the study period when ICD-9-CM codes were in use at KPWA, i.e., 1/1/2010-9/30/2015
  5. dThe ICD-10-CM era corresponds to the time during the study period when ICD-10-CM codes were in use at KWPA, i.e., 10/1/2015-12/31/2020
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