Introduction Emergency department (ED) visit discharge data are a less explored population-based data source used to identify work-related injuries. When using discharge data, work-relatedness is often determined by the expected payer of workers’ compensation (WC). In October 2015, healthcare discharge data coding systems transitioned to the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM). ICD-10-CM’s structure offers potential new work-related codes to enhance work-related injury surveillance. This study identified work-related ED visits using relevant ICD-10-CM work-related injury codes. Cases identified using this method were compared with those identified using the WC expected payer approach. Methods State ED visit discharge data (2016–2019) were analysed using the CDC’s discharge data surveillance definition. Injuries were identified using a diagnosis code or an external cause-of-injury code in any field. Injuries were assessed by mechanism and expected payer. Literature searches and manual review of ICD-10-CM codes were conducted to identify possible work-related injury codes. Descriptive statistics were performed and assessed by expected payer. Results WC was billed for 87 361 injury ED visits from 2016 to 2019. Falls were the most frequent injury mechanism. The 246 ICD-10-CM work-related codes identified 36% more work-related ED injury visits than using WC as the expected payer alone. Conclusion This study identified potential ICD-10-CM codes to expand occupational injury surveillance using discharge data beyond the traditional WC expected payer approach. Further studies are needed to validate the work-related injury codes and support the development of a work-related injury surveillance case definition.

中文翻译：

---

使用国际疾病分类第十修订版临床修改 (ICD-10-CM) 代码识别工伤急诊就诊

简介 急诊科 (ED) 就诊出院数据是一种较少探索的基于人群的数据源，用于识别工伤。当使用出院数据时，工作相关性通常由工伤赔偿 (WC) 的预期支付者决定。2015 年 10 月，医疗保健出院数据编码系统过渡到国际疾病分类第十版临床修改版 (ICD-10-CM)。ICD-10-CM 的结构提供了潜在的新工作相关代码，以加强工伤监测。本研究使用相关 ICD-10-CM 工伤代码确定了与工作相关的急诊就诊。使用此方法确定的案例与使用 WC 预期付款人方法确定的案例进行了比较。方法 使用 CDC 的出院数据监测定义对州急诊就诊出院数据（2016-2019 年）进行分析。使用任何领域的诊断代码或外部伤害原因代码来识别伤害。伤害由机制和预期付款人评估。对ICD-10-CM代码进行文献检索和人工审查，以确定可能的工伤代码。描述性统计由预期付款人进行和评估。结果 2016 年至 2019 年间，WC 收取了 87 361 次受伤急诊就诊费用。跌倒是最常见的伤害机制。与单独使用 WC 作为预期付款人相比，246 个 ICD-10-CM 工作相关代码确定的与工作相关的 ED 伤害就诊次数多了 36%。结论 本研究确定了潜在的 ICD-10-CM 代码，可使用传统 WC 预期付款人方法之外的出院数据来扩大职业伤害监测。需要进一步研究来验证工伤法规并支持工伤监测案例定义的制定。