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The pre-implementation PAAR in October 2013 was 33.1%, and the immediate influence of ICD-10 transition on PAAR was 3.2% (P=0.002), with a 0.38% per quarter increase over time (P=0.02). After adjusting for age, gender, race/ethnicity, payer, and year, the likelihood of being documented as having perforated appendicitis in 2016 was 1.5 times higher than the estimated likelihood before the implementation (adjusted Odds Ratio 1.51; 95% Confidence Interval 1.40-1.63; P 0.001). The 2015-2018 ICD-10 transition may be erroneously associat
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