Trends in Opioid-Related Inpatient Stays Shifted After Switch to ICD-10 Coding Interview with:

Anne Elixhauser, Ph.D. Senior Research Scientist Agency for Healthcare Research and Quality Rockville MD 20857

Dr. Elixhauser

Anne Elixhauser, Ph.D.
Senior Research Scientist
Agency for Healthcare Research and Quality
Rockville MD 20857 What is the background for this study? What are the main findings?

Response: Hospital inpatient data began using ICD-10-CM (I-10) codes on October 1, 2015.  We have been doing analysis using the new codeset to determine to what extent we can follow trends crossing the ICD transition—do the trends look consistent when we switch from I-9 to I-10?  Tracking the opioid epidemic is a high priority so we made this one of our first detailed analyses.  We were surprised to find that hospital stays jumped 14% across the transition, compared to a 5% quarterly increase before the transition (under I-9) and a 3.5% quarterly increase after the transition (under I-10).  The largest increase (63.2%) was for adverse effects in therapeutic use (side effects of legal drugs), whereas stays involving opioid abuse decreased 21% and opioid poisoning (overdose) decreased 12.4%. What should readers take away from your report?

Response: We encourage researchers and other users of hospital data to use caution when examining trends that cross the ICD-10-CM transition.  Carefully look at the numbers of cases over time, by month or quarter, to assess what potential impact the I-10 transition had on the numbers of cases identified.  Also be sure to look at individual ICD codes or groups of codes as we did here to identify where bumps in trend lines may be originating—we found remarkable differences across different types of opioid codes—side effects of legal drugs, abuse, and overdose. What recommendations do you have for future research as a result of this study?

Response: Carefully assess how the numbers of cases differ across the I-10 transition, analyze the data by patient subgroups, and take care in drawing conclusions about trends that cross the time during which ICD-10-CM was introduced. Thank you for your contribution to the community.


Med Care. 2017 Nov;55(11):918-923. doi: 10.1097/MLR.0000000000000805.

Trends in Opioid-related Inpatient Stays Shifted After the US Transitioned to ICD-10-CM Diagnosis Coding in 2015.

Heslin KC1, Owens PL, Karaca Z, Barrett ML, Moore BJ, Elixhauser A.

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions. 

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Last Updated on October 24, 2017 by Marie Benz MD FAAD