Abstract
Objective: The opioid epidemic has led to a surge in diagnoses of neonatal opioid withdrawal syndrome (NOWS). Many states track the incidence of NOWS by using the P96.1 International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) code for “neonatal withdrawal symptoms from maternal use of drugs of addiction.” In October 2018, an ICD-10-CM code for neonatal opioid exposure (P04.14) was introduced. This code can be used when an infant is exposed to opioids in utero but does not have clinically significant withdrawal symptoms. We analyzed the effect of the P04.14 code on the incidence rate of NOWS (P96.1) and “other” neonatal drug exposure diagnoses (P04.49). Methods: We used private health insurance data collected for infants in the United States from the first quarter of 2016 through the third quarter of 2021 to describe incidence rates for each code over time and examine absolute and percentage changes before and after the introduction of code P04.14. Results: The exclusive use of code P96.1 declined from an incidence rate per 1000 births of 1.08 in 2016-2018 to 0.70 in 2019-2021, a −35.7% (95% CI, −47.6% to −23.8%) reduction. Use of code P04.49 only declined from an incidence rate of 2.34 in 2016-2018 to 1.64 in 2019-2021, a −30.0% (95% CI, −36.4% to −23.7%) reduction. Use of multiple codes during the course of treatment increased from an average incidence per 1000 births of 0.56 in 2016-2018 to 0.79 in 2019-2021, a 45.5% (95% CI, 24.8%-66.1%) increase. Conclusion: The introduction of ICD-10-CM code P04.14 altered the use of other neonatal opioid exposure codes. The use of multiple codes increased, indicating that some ambiguity may exist about which ICD-10-CM code is most appropriate for a given set of symptoms.
Original language | English (US) |
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Pages (from-to) | 88-93 |
Number of pages | 6 |
Journal | Public health reports |
Volume | 139 |
Issue number | 1 |
DOIs | |
State | Published - Jan 1 2024 |
Funding
The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was funded, in part, with support from the National Center for Advancing Translational Sciences, Indiana Clinical Translational Sciences Institute (UL1TR001108 and TL1TR002531), the Richard M. Fairbanks Foundation, and the Indiana University Grand Challenge program, Responding to the Addictions Crisis. The funder/sponsor did not participate in the work.
Keywords
- console
- eat
- neonatal abstinence syndrome
- neonatal opioid withdrawal syndrome
- opioid epidemic
- sleep
ASJC Scopus subject areas
- Public Health, Environmental and Occupational Health