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Table 3 Indicators of persistent morbidity

From: VA Vascular Injury Study (VAVIS): VA-DoD extremity injury outcomes collaboration

Indicators of persistent morbidity

Data used to identify

Data source

Use of unscheduled or emergency care for vascular issues

DSS Clinic Identifier and ICD-9 Codes

Outpatient (OPC) files; VA-CMS

Use of scheduled care for polytrauma vascular issues

DSS Clinic Identifier and ICD-9 Codes

OPC files; VA-CMS

Long-term use/escalating dose of opioid medications

VA Product, Dose, Day Supply

Pharmacy Benefits Management (PBM) Data; Medicare Part D VA-CMS

NDC Code

Trajectory of chronic pain (latent class analysis of pain scores from TRACC)

Pain Score

CDW vitals

Conditions indicative of persistent morbidity (e.g., Venous stasis disease/venous ulcers, lymphedema)

ICD-9 Codes including but not limited to 729.81, 782.3, 729.5, 415.19, 451.11, 451.19 451.83, 451.82, V72.83

PTF, OPC files, VA-CMS

Prescriptions for compression stockings and wound care supplies (e.g., wound vac) indicative of swelling, venous stasis disease

VA Class

PBM Data, VA-CMS Durable Medical Equipment

XA

Use of prosthetic/orthotic devices (canes, walkers, special shoes, etc).

Health Care Financing Administration Coding System (HCPCS) Prosthetic and Sensory Aids Service (PSAS) Code;

National Prosthetics database

CMS Durable Medical Equipment

Additional procedures (open or endovascular) on the injured extremity

CPT-4; ICD-9A procedure codes

OPC/PTF VA-CMS

Chronic antibody use (osteo or other potential infectious issues with the limb)

VA Product

PBM Data; Medicare Part D VA-CMS

Duplex ultrasound, MRA/CTA or angiogram to evaluate the repair

CPT-4 procedure codes including but not limited to 93970, 93971, 93975, 93976, 93978, 93979, 93922, 93923, 93925, 93926, 93930, 93931, 93924

OPC/PTF; VA-CMS

Mean pain scores over 4

Pain Score Mean per year

Corporate data warehouse Vital Signs

Proportion of VA care

Visits VA/ Total Visits

OPC/PTF; VA CMS outpatient/inpatient

Mortality

Date of Death

VA Vital Status file