背景：許多研究使用國際疾病分類編碼找尋BC型肝炎病患，可是探討編碼準確度的研究相對較少，而且目前沒有研究比較第十版與第九版的準確度指標差異。
目的：比較不同BC肝炎國際疾病分類編碼審定程序與版本的準確度指標差異以及相關影響因素。
方法：本研究系統隨機抽樣南部一醫療體系穩定就醫病患一萬人。納入抽樣的病患條件為2015年至少四次就醫且年齡20歲以上個案，醫學中心院區抽樣6000人，區域醫院院區抽樣2500人，地區醫院院區抽樣1500人。透過2005至2019年電子病歷紀錄判斷病患是否有BC型肝炎的金字標準包括：有處方BC型肝炎藥物，相關檢驗報告陽性，臨床醫師在病歷有診斷。接著計算門診或住院診斷出現BC型肝炎編碼次數界定不同審定程序，分別計算敏感度、特異度、陽性預測值與陰性預測值。最後分析與這些準確度指標的相關影響因素與似然比。
結果：本究確認出BC型肝炎病患分別為726與555位。審定程序單用門診出現B肝編碼診斷次數1次，2次與3次的陽性預測值是72%，77%與80%，敏感度是72%，69%與63%。審定程序如果加上住院診斷出現1次或門診出現2次，3次與4次的陽性預測值分別是77%，80%與81%，敏感度提高為76%，72%與69%。審定程序單用門診出現C肝編碼診斷次數1次，2次與3次的陽性預測值是88%，92%與94%，敏感度是75%，72%與68%。審定程序如果加上住院診斷出現1次或門診出現2次，3次與4次的陽性預測值分別是91%，93%與94%，敏感度提高為81%，77%與73%。由第九版改為第十版，以門診出現3次的審定程序為例，陽性預測值B肝由80%提高到90%，C肝由94%提高到99%。醫學中心或區域醫院資料、消化系內科個案、年紀大於40歲個案的編碼準確度都相對較高。
結論：台灣健保申報資料C型肝炎國際疾病編碼編碼準確度優於B型肝炎，BC型肝炎編碼準確度在第十版都優於第九版。研究者如果只考量陽性預測值，審定程序只使用門診申報診斷次數3次就可以達到相當高的水準。如果還考慮不要太低敏感度，可以加上或出現1次住院診斷的條件。

Background: Many studies used different algorithms of the International Classification of Diseases (ICD) codes to identify patients with hepatitis B and C virus infection (HBV and HCV); yet, relatively few validation studies on these algorithms and between Ninth Revision and Tenth Revision (ICD-9-CM and ICD-10-CM). Methods: We systematic randomly sampled 10,000 patients in a healthcare system in southern Taiwan, in which 6000 people from the medical center, 2500 from the regional hospital and 1500 from the district hospital. We reviewed electronic medical record system for years from 2005 to 2019 to determine whether the patient had HBV or HCV based on the prescription records, laboratory results, and text diagnosis by physicians. We then used the number of HBV or HCV ICD codes occurred in outpatient or inpatient claims data to define different algorithms. Different indicators of validity such as sensitivity, specificity, positive predictive value (PPV) and negative predictive value were calculated. Lastly, we examined associated factors with these indicators and likelihood ratios. Results: We identified 726 patients with HBV and 55 patients with HCV. The PPV for algorithm HBV ICD codes occurred in outpatient claims data at least 1, 2, and 3 times was 72%, 77%, and 80%, respectively and the sensitivity was 72%, 69%, and 63%, respectively. The PPV for algorithm HBV ICD codes occurred in inpatient claims data once or outpatient claims data at least 2, 3, and 4 times was 77%, 80%, and 81%, respectively and the sensitivity increased to 76%, 72%, and 69%, respectively. The PPV for algorithm HCV ICD codes occurred in outpatient claims data at least 1, 2, and 3 times was 88%, 92%, and 94%, respectively and the sensitivity was 75%, 72%, and 68%, respectively. The PPV for algorithm HCV ICD codes occurred in inpatient claims data once or outpatient claims data at least 2, 3, and 4 times was 91%, 93%, and 94%, respectively and the sensitivity increased to 81%, 77%, and 73%, respectively. Using algorithm at least 3 times of ICD codes in outpatient claims data as example, the PPV from ICD-9-CM to ICD-10-CM was 80% to 90% for HBV and 94% to 99% for HCV. The higher the level of hospital and the older the patients and patients visited gastroenterologists had better performance of ICD codes. Conclusion: The accuracy of HCV ICD coding was better than HBV coding. For both HBV and HCV, the accuracy was better in ICD-10-CM than in ICD-9-CM. If researchers considered only PPV, the algorithm using outpatient claims data with at least 3 times of HBV or HCV ICD codes could reach the relative high PPV level. If researchers also consider the sensitivity, we suggested of addition of at least 1 time of ICD code in inpatient claims in the algorithm.

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