In Reply We appreciate the interest in our analysis by Xia and colleagues and their discussion of our use of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) for code validation. As they have indicated, the positive predictive values of ICD-9-CM codes 692.71 (first-degree sunburn) and 692.76 (second-degree sunburn) support our search criteria. The remaining code used in our search criteria, ICD-9-CM code 692.77, is for third-degree sunburn. This event is highly unusual, so it is not a surprise that they found no cases with this code in their data set. Although we did not analyze our data by specific codes, we did note that there were only 11 (0.15%) visits in our data set with a code of 692.77.
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