Differences in the Measurement of Comorbidities Based on ICD-10-CM Coding Definitions Using Medicare Advantage Encounter Data and Fee-For-Service Claims

Discrepancies in comorbidity prevalence may reflect true differences or coding variations influenced by provider incentives, documentation standards, or diagnostic priorities. Comorbidity prevalence was largely consistent between MA encounters and FFS claims, supporting the reliability of MA encounter data for aging research. Additional validation studies should address remaining discrepancies.

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Publication Details

Journal
Medical Care
Published
2026-01-20
DOI
https://doi.org/10.1097/mlr.0000000000002282
Primary Topic
Medical Coding and Health Information
Type
article
Field-Weighted Citation Impact
0.00
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article

Differences in the Measurement of Comorbidities Based on ICD-10-CM Coding Definitions Using Medicare Advantage Encounter Data and Fee-For-Service Claims

Emilie Danielle Duchesneau, Michael Webster‐Clark, E. Basch, Anna G Kuzma et al.
Medical Care
Medical Coding and Health Information
article

Differences in the Measurement of Comorbidities Based on ICD-10-CM Coding Definitions Using Medicare Advantage Encounter Data and Fee-For-Service Claims

Emilie Danielle Duchesneau, Michael Webster‐Clark, E. Basch, Anna G Kuzma, Allison Musty, Amresh Hanchate, Dae Hyun Kim, Meng-Yun Lin, Bailey Reutinger, Til Stürmer
article en

Abstract

Discrepancies in comorbidity prevalence may reflect true differences or coding variations influenced by provider incentives, documentation standards, or diagnostic priorities. Comorbidity prevalence was largely consistent between MA encounters and FFS claims, supporting the reliability of MA encounter data for aging research. Additional validation studies should address remaining discrepancies.

Medical CareVol. 64(3)
University of North Carolina at Chapel Hill (US), Beth Israel Deaconess Medical Center (US), Hebrew SeniorLife (US), Wake Forest University (US)
Openalex Percentile: Top 85%
Medical Coding and Health Information
DOIOpen Access PDFOpenAlex
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Differences in the Measurement of Comorbidities Based on ICD-10-CM Coding Definitions Using Medicare Advantage Encounter Data and Fee-For-Service Claims — Emilie Danielle Duchesneau, Michael Webster‐Clark, et al. · Medical Care (2026) | TGRS Research Map | TGRS