To the Editor: Tunis et al. (Aug. 22 issue)1 question the use of balloon angioplasty, on the basis of an analysis of amputation rates over a 10-year period in Maryland hospitals. They noted a 24-fold increase in angioplasty, from 17 to 706 procedures, between 1979 and 1989, with no significant change in the amputation rate (30 procedures per 100,000 residents). Estimating the number of lower-extremity angioplasties from the codes of the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) is flawed. A potentially large group of unrelated procedures could have been included in the 39.59 code group, which includes. . .
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