The Barell

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The Barell Body Region by Nature of Injury
Diagnosis Matrix
Aharonson-Daniel L Presenting the work of the
late Vita Barell in conjunction with Avitzour M,
Boyko V, Ziv A, Heruti R, Abargel A,
ISRAEL Mackenzie E, Fingerhut L, USA And many
dear friends from the ICE on Injury
The Center for Trauma and Emergency Medicine
Research, Gertner Institute for Epidemiology and
Health Policy Research, Israel
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What is the Matrix?
The Matrix is a tool for classifying injury
ICD-9-CM codes by body region and nature of
injury. It is useful for standardized retrieval
of injury cases for epidemiological, clinical and
management oriented analyses.
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Matrix objectives

• To simplify the process of classifying injuries

• To provide a standard format for reports

• To serve as a standard for casemix comparison

• To characterize the patterns of injury

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Motivation for building the matrix
ICD 9-CM CODES 800-995
Sorted by nature of injury
Detecting injuries by body region requires
collating codes across chapters
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Motivation for building the matrix
ICD 9-CM CODES 800-995
nature of injury
body region
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The Matrix structure
Nature of injury
Body Region
ICD-9-CM injury codes

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Nature of injury (Columns) are based on Sequence
of codes in ICD-9-CM codebook
12 Nature of Injury Columns Fractures,
dislocations, sprains strains, internal, open
wounds, amputations, blood vessels,
contusions/superficial, crush, burn, nerves
unspecified
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Body Region (Rows) are based on Anatomic
subgroups High Incidence Variability in
Outcome Difference in health care utilization
3 standard levels of detail 5 rows 10 rows 36 rows
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matrix

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Zoom on matrix

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Example
Fractures
Internal
Blood Vessels
800.4 Skull fracture
850 Concussion
Head
Spinal Cord
860 Flail chest
Chest
824 Fractured ankle
Lower extremity
Jack skull Jill - concussion John Flail
chest Peter - ankle
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Summary Report
Number

(50)
Head
2
0
(0)
Spinal Cord
1
(25)
Chest
1
(25)
Lower extremity
4
N
Total
100
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Summary report in practice
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Using report for comparisons
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Forthcoming developments
Collaboration with CDC NCIPC, academic and other
Neurological organizations about the structure
and interpretation of Severity of TBI rows
Develop standard methods for summarizing
multiple injuries Translate into ICD-10
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Thanks for your attention
A handout of the matrix is available
The matrix is also on the net at
www.cdc.gov/nchs/projects/barellmatrix.htm