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What ICD-9-CM codes are used to identify inpatient & outpatient cases with drug overdose?
Inpatient and outpatient data are coded using ICD-9-CM. Poisoning by drugs, medicinal and biological substances is coded with ICD-9-CM diagnostic codes 960-979. Poisoning by analgesics, antipyretics, and antirheumatics is 965, with opiates and related narcotics as 965.0. For the subset of opiates and related narcotics, heroin code is 965.01 and methadone code is 965.02. Poisoning by sedatives and hypnotics is 967.
It is important to look at the data notes on prepared reports to ensure accurate comparisons across different sources. It is important to consult an ICD-9-CM coding book or website to identify codes for desired codes.
What ICD-10 codes are used to identify drug overdose deaths?
Drug overdose deaths are typically first identified through underlying cause of death coded on death certificate as drug overdose fatality or “acute drug overdose” (ICD-10 codes: X40-X44.9, X60-X64, X85, Y10-Y14.9). Then, drug-specific overdose deaths were identified through 10 contributory cause of death fields based on the appropriate ICD-10 codes. For instance, for specific-drug related deaths, heroin ICD-10 code is T40.1; opioid pain reliever codes are T40.2, T40.3, and T40.4; benzodiazepine code is T42.8; and cocaine code is T40.5.
It is important to look at the data notes on prepared reports to ensure accurate comparisons across different sources. It is important to consult an ICD-10 coding book or website to identify codes for desired codes. These recommendations are based on the guidelines from: Gabella BA, Proescholdbell SK, Hume B, et. al. State Special Emphasis Report: Instructions Drug Overdose Data. Atlanta (GA): Centers for Disease Control and Prevention, National Center for Injury Prevention and Control; 2014.
Overdose: When a drug is swallowed, inhaled, injected, or absorbed through the skin in excessive amounts and injures the body. Overdoses are either intentional or unintentional. If the person taking or giving a substance did not mean to hurt themselves or others, then it is unintentional.
Misuse: The use of prescription drugs in a manner other than as directed.
Abuse: Continued use of illicit or prescription drugs despite problems from drug use with relationships, work, school, health, or safety. People with substance abuse often experience loss of control and take drugs in larger amounts or for longer than they intended.
Diversion: The use of prescription drugs for recreational consumption, such as diverting them from their original medical purpose.
Naloxone (also known as Narcan): A prescription drug that can reverse an opioid or heroin overdose if administered in time.
Poisoning: Injury or death due to the ingestion, inhalation, absorption through the skin, or injection of a drug, toxin, or other chemical such as gases and corrosives. Examples of poisonings include harmful effects resulting from exposure to alcohol, disinfectants, cleansers, paints, insecticides, and caustics.
Prescription Drug Monitoring Programs (PDMPs): State-run electronic databases used to track the prescribing and dispensing of controlled prescription drugs to patients.
Opioid: Derived from the opium poppy (or synthetic versions of it) and used for pain relief. Examples include hydrocodone (Vicodin®), oxycodone (OxyCotin®, Fentora®), methadone, and codeine.
Benzodiazepine: Central nervous system depressants used as sedatives, to induce sleep, prevent seizures, and relieve anxiety.
CDC: Centers for Disease Control and Prevention
DMHA: Division of Mental Health and Addiction
ED: Emergency Department
EMS: Emergency Medical Services
ICD-9- CM: International Classification of Disease- Ninth Revision – Clinical Modification
ICD-10: International Classification of Diseases – Tenth Revision
NAS: Neonatal Abstinence Syndrome
PDO: Prescription Drug Overdose
SAMHSA: Substance Abuse and Mental Health Services Administration
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